Healthcare Provider Details
I. General information
NPI: 1750868089
Provider Name (Legal Business Name): VILV ZEETSER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
375 N STEPHANIE ST STE 1011
HENDERSON NV
89014-8901
US
IV. Provider business mailing address
18375 VENTURA BLVD STE 554
TARZANA CA
91356-4218
US
V. Phone/Fax
- Phone: 702-844-6958
- Fax: 866-443-1452
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARA
ARREDONDO
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 702-844-6958