Provider Demographics
NPI:1053975847
Name:CALIFORNIA VASCULAR & INTERVENTIONAL PC.
Entity type:Organization
Organization Name:CALIFORNIA VASCULAR & INTERVENTIONAL PC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-409-4114
Mailing Address - Street 1:8549 WILSHIRE BLVD # 14157
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3104
Mailing Address - Country:US
Mailing Address - Phone:323-546-7993
Mailing Address - Fax:213-800-0806
Practice Address - Street 1:145 N ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2103
Practice Address - Country:US
Practice Address - Phone:310-409-4114
Practice Address - Fax:213-800-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty