Healthcare Provider Details

I. General information

NPI: 1679951362
Provider Name (Legal Business Name): USA VASCULAR CENTERS OF LOS ANGELES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12840 RIVERSIDE DR SUITE 300A
VALLEY VILLAGE CA
91607-3327
US

IV. Provider business mailing address

304 WAINWRIGHT DR STE 130
NORTHBROOK IL
60062-1919
US

V. Phone/Fax

Practice location:
  • Phone: 323-798-1800
  • Fax: 224-246-8042
Mailing address:
  • Phone: 847-257-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER A MORRISON
Title or Position: OWNER
Credential:
Phone: 727-644-3038