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General NPI Number Information
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NPI Number | 1578882965
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Entity Type | Organization
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Legal Business Name | PACIFIC VASCUCARE, INC.
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1660 W 3RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90017-1138
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Country | US
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Telephone | 213-201-0850
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 412672
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City | BOSTON
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State | MA
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Zip | 02241-2672
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Country | US
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Telephone | 610-644-8900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE A. GREENFIELD
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Credential | M.D.
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Telephone | 213-201-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State | CA
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