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1255315222

NPI Code Detail

MEDICARE: DR. MARK STEVEN VRAHAS MD

MEDICARE: DR. MARK STEVEN VRAHAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	160413	MA
2	207X00000X	Orthopaedic Surgery Physician	G145660	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	401688	OTHER	MA	TUFTS HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	J21515	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1255315222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK STEVEN VRAHAS MD

Provider Business Mailing Address
First Line	:	444 S SAN VICENTE BLVD STE 603
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4178
Country	:	US
Telephone Number	:	310-423-5877
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 S SAN VICENTE BLVD STE 603
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4178
Country	:	US
Telephone Number	:	310-423-5877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	11/14/2016

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Directions to “ DR. MARK STEVEN VRAHAS MD” Practice Location

Language	Start Address	Practice Location

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