Provider Demographics
NPI:1053170548
Name:AVA VASCULAR SURGERY CENTER
Entity type:Organization
Organization Name:AVA VASCULAR SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-755-0523
Mailing Address - Street 1:1868 S WESTSIDE DR UNIT 28
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-7472
Mailing Address - Country:US
Mailing Address - Phone:585-755-0523
Mailing Address - Fax:951-574-6501
Practice Address - Street 1:25485 MEDICAL CENTER DR STE 106
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6927
Practice Address - Country:US
Practice Address - Phone:951-574-6500
Practice Address - Fax:951-574-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty