Healthcare Provider Details

I. General information

NPI: 1124818406
Provider Name (Legal Business Name): ARTERIAL INTERVENTIONAL CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W GARVEY AVE STE 102-502
MONTEREY PARK CA
91754-7418
US

IV. Provider business mailing address

201 W GARVEY AVE STE 102-502
MONTEREY PARK CA
91754-7418
US

V. Phone/Fax

Practice location:
  • Phone: 909-574-4686
  • Fax:
Mailing address:
  • Phone: 909-574-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTOR SHI
Title or Position: OWNER
Credential: MD
Phone: 909-684-4404