Provider Demographics
NPI:1730361163
Name:EXPERIENCED VASCULAR IMAGING CORPORATION
Entity type:Organization
Organization Name:EXPERIENCED VASCULAR IMAGING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUERTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-254-6243
Mailing Address - Street 1:23135 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3611
Mailing Address - Country:US
Mailing Address - Phone:661-254-6243
Mailing Address - Fax:661-254-8532
Practice Address - Street 1:23135 MARKET ST
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-3611
Practice Address - Country:US
Practice Address - Phone:661-254-6243
Practice Address - Fax:661-254-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Single Specialty