Organization
MODERN VASCULAR OF MEMPHIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YURY GAMPEL (MANAGER)
(818) 262-6423
Entity
Organization
Contact information
Practice address
5645 MURRAY AVE, MEMPHIS, TN 38119-3831
(901) 633-1190
(901) 881-7979
Mailing address
26500 AGOURA RD STE 102-587, CALABASAS, CA 91302-1952
(818) 880-8605
Taxonomy
Speciality
Code
Description
License number
State
2471C1101X
Cardiovascular-Interventional Technology Radiologic Technologist
—
—
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
Primary
—
—
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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