MEDICARE: VINCENT MANUEL TRISTAN PA

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	363A00000X	Physician Assistant	PA13719	CA

General Provider Information

NPI Number	:	1598716151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT MANUEL TRISTAN PA

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 SAN PABLO ST
Second Line	:	2ND FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5320
Country	:	US
Telephone Number	:	323-442-5908
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	11/27/2023

Similar Medicare Providers

1225012776 — MS. NANCY DANZ SHEBEL MSN, RN, NP-C
Practice Location Address:

1510 SAN PABLO ST , SUITE 514
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-5951
Practice Fax: 323-442-5735

1457326266 — LIDIJA PETROVIC MD
Practice Location Address:

1510 SAN PABLO ST FL 6
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-4815
Practice Fax:

1457311797 — HEIDI LEE FRANKEL MD
Practice Location Address:

1510 SAN PABLO STREET
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-5907
Practice Fax: 323-442-6020

1528009941 — DR. HOSSEIN JADVAR M.D.
Practice Location Address:

1510 SAN PABLO ST FL 3
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-8541
Practice Fax:

1295764447 — NIR WASSERBERG MD
Practice Location Address:

1510 SAN PABLO ST , SUITE 514
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-6811
Practice Fax: 323-442-5756

1023032133 — DR. KAUSHAL RAMESH PATEL MD
Practice Location Address:

1510 SAN PABLO ST , SUITE 514
LOS ANGELES, CA
90033-5320

Practice Phone: 323-442-5988
Practice Fax: 323-442-5735

Directions to “ VINCENT MANUEL TRISTAN PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.