Healthcare Provider Details

I. General information

NPI: 1891723607
Provider Name (Legal Business Name): VASCULAR & GENERAL SURGERY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3791 KATELLA AVE STE 201
LOS ALAMITOS CA
90720-2016
US

IV. Provider business mailing address

3791 KATELLA AVE STE 201
LOS ALAMITOS CA
90720-2016
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-6736
  • Fax: 562-598-5492
Mailing address:
  • Phone: 562-596-6736
  • Fax: 562-598-5492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SIMON B RAYHANABAD
Title or Position: SURGEON/GENERAL PARTNER
Credential:
Phone: 562-596-6736