Basic Information
| Provider Information | |||||||||
| NPI: | 1629070610 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VASCULAR AND INTERVENTIONAL SPECIALISTS OF ORANGE COUNTY, INC. | ||||||||
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| OtherOrganizationName: | FLANIGAN AND HARWARD, A MEDICAL CORPORATION | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1140 W LA VETA AVE STE 850 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928684218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145604450 | ||||||||
| FaxNumber: | 7145604455 | ||||||||
| Practice Location | |||||||||
| Address1: | 1140 W LA VETA AVE | ||||||||
| Address2: | STE. 850 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928684218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145604450 | ||||||||
| FaxNumber: | 7145604455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 06/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | FLANIGAN | ||||||||
| AuthorizedOfficialFirstName: | D. PRESTON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7145604450 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2086S0129X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.