MEDICARE: PACIFIC INTERVENTIONAL VASCULAR ACCESS CENTER MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RC0000X	Cardiovascular Disease Physician
2	2086S0129X	Vascular Surgery Physician
3	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1942593918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC INTERVENTIONAL VASCULAR ACCESS CENTER MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	40 VALLEY STREAM PKWY
Second Line	:	SUITE 100
City	:	MALVERN
State	:	PA
Zip	:	19355-1407
Country	:	US
Telephone Number	:	610-644-8900
Fax Number	:

Provider Business Practice Location Address
First Line	:	6076 BRISTOL PKWY STE 108
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6600
Country	:	US
Telephone Number	:	310-348-9604
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	SPENCER BROWN
Credential	:	MD
Telephone Number	:	310-348-9604

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	11/26/2024

Similar Medicare Providers

1053490755 — CENTURY CITY SURGICAL ASSOCIATES A MEDICAL CORPORATION ASSOCIATES MEDI
Practice Location Address:

6076 BRISTOL PKWY STE 108
CULVER CITY, CA
90230-6600

Practice Phone: 310-348-9604
Practice Fax: 310-338-1219

1649429572 — ACCORD HOME HEALTH SERVICES INC
Practice Location Address:

6076 BRISTOL PKWY , SUITE 202
CULVER CITY, CA
90230-6600

Practice Phone: 310-338-7160
Practice Fax: 310-338-7159

1255624631 — DR. ANDREA FINKELSTEIN SHERMAN OTD, OTR/L
Practice Location Address:

6076 BRISTOL PKWY , SUITE 105
CULVER CITY, CA
90230-6600

Practice Phone: 310-642-7700
Practice Fax: 310-645-0394

1154759686 — MRS. KATHLYN FORTUNE MS CCC-SLP
Practice Location Address:

6076 BRISTOL PKWY , STE 105
CULVER CITY, CA
90230-6600

Practice Phone: 310-642-7700
Practice Fax:

1649692260 — CAROL SUZUKI
Practice Location Address:

6076 BRISTOL PKWY , SUITE 105
CULVER CITY, CA
90230-6600

Practice Phone: 562-547-1590
Practice Fax:

1871918185 — JESSICA GALVEZ
Practice Location Address:

6076 BRISTOL PKWY STE 105
CULVER CITY, CA
90230-6600

Practice Phone: 310-642-7700
Practice Fax:

Directions to “PACIFIC INTERVENTIONAL VASCULAR ACCESS CENTER MEDICAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.