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Tri-state Vascular Group, Pllc
General Practice Physician in Needles, California
NPI 1366993818

Tri-state Vascular Group, Pllc is a General Practice Physician based in Fort Mohave, CA. Tri-state Vascular Group, Pllc practices in Needles, CA. The NPI Number for Tri-state Vascular Group, Pllc is 1366993818 and holds a License No. (California).

The current practice location address for Tri-state Vascular Group, Pllc is 1401 Bailey Ave Bldg A, Needles, CA and can be reached out via phone at 960-590-0155 and via fax at 760-326-7170.

Location: 1401 Bailey Ave Bldg A, Needles, CA, 86427-9893
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1366993818
Provider Name
Tri-state Vascular Group, Pllc
Credential
Provider Entity Type
Organization
Address
1401 Bailey Ave Bldg A, Needles, CA, 86427-9893
Phone Number
960-590-0155
Fax Number
760-326-7170
Provider Enumeration Date
10/19/2016
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P20421635 01 AZ CORPORATION REGISTRATION NUMBER
205332 05 AZ
institution
Provider Business Practice Location Address Details
Address
1401 Bailey Ave Bldg A
City
Needles
State
California
Zip
92363-3103
Phone Number
960-590-0155
Fax Number
760-326-7170
person
Provider Business Mailing Address Details
Address
1401 Bailey Ave Bldg A
City
Needles
State
California
Zip
92363-3103
Phone Number
960-590-0155
Fax Number
760-326-7170
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
()
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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