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General NPI Number Information
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NPI Number | 1881930949
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY VASCULAR CENTER A CA PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 255 N ELM ST SUITE 204
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City | ESCONDIDO
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State | CA
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Zip | 92025-3431
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Country | US
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Telephone | 760-294-0870
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Fax | 760-294-0871
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Provider Business Mailing Address
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Address Line | 255 N ELM ST SUITE 204
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City | ESCONDIDO
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State | CA
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Zip | 92025-3431
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Country | US
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Telephone | 760-294-0870
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Fax | 760-294-0871
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OSMAN KHAWAR
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Credential | MD
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Telephone | 760-745-1551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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