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General NPI Number Information
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NPI Number | 1295706901
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Entity Type | Organization
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Legal Business Name | VASCULAR & THORACIC ASSOCIATES OF LOS ANGELES
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 3680 E IMPERIAL HWY SUITE 502
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City | LYNWOOD
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State | CA
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Zip | 90262-2659
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Country | US
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Telephone | 562-698-0271
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Fax | 562-698-7467
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Provider Business Mailing Address
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Address Line | 3680 E IMPERIAL HWY SUITE 502
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City | LYNWOOD
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State | CA
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Zip | 90262-2659
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Country | US
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Telephone | 562-698-0271
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Fax | 562-698-7467
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE SPIWAK
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Credential | M.D.
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Telephone | 562-698-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A32316
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License Number State | CA
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