Organization · NPI-2
Avanguard Medical Group INC
Radiologic Technologist, Vascular-Interventional Technology · Tarzana, CA
NPI number1336746221
StatusActive
Last updated in NPPESOct 5, 2020
Details
- NPI
- 1336746221
- Entity type
- Organization (NPI-2)
- Legal business name
- Avanguard Medical Group INC
- Organization subpart
- No
- Enumeration date
- Oct 5, 2020
- Certification date
- Oct 5, 2020
- Last updated
- Oct 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471V0106X | Radiologic Technologist, Vascular-Interventional Technology | – | – | Yes |
Practice location
5620 Wilbur Ave Ste 207Tarzana, CA 91356-1309
Phone 818-344-0070
Mailing address
5620 Wilbur Ave Ste 207Tarzana, CA 91356-1309
Phone 818-344-0070
Authorized official
Victoriya Tepman
Administrator
8183440070
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