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General NPI Number Information
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NPI Number | 1841810363
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Entity Type | Organization
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Legal Business Name | VEIN PLACE INC
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 1945 E 17TH ST STE 107
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City | SANTA ANA
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State | CA
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Zip | 92705-6862
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Country | US
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Telephone | 714-366-6666
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 E 17TH ST STE 107
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City | SANTA ANA
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State | CA
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Zip | 92705-6862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY SHARIFI
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Credential |
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Telephone | 714-500-7714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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