MODERN VASCULAR OF FAIRFAX, LLC

FAIRFAX, VA
NPI1821553108
Entity TypeOrganization
Authorized ContactYURY GAMPEL
Manager
818-880-8605
Organization Subpart ?No
Primary Taxonomy2085R0204X Radiology Vascular & Interventional Radiology
Additional Taxonomies2471V0106X Radiologic Technologist Vascular-Interventional Technology
Enumeration Date2019-01-31
Last Update Date2019-01-31
Business Address
MODERN VASCULAR OF FAIRFAX, LLC
2812 OLD LEE HWY STE 100B
FAIRFAX, VA 22031-4315
Phone number: 571-279-6849
Mailing Address
MODERN VASCULAR OF FAIRFAX, LLC
26500 AGOURA RD STE 102-587
CALABASAS, CA 91302-1952
Phone number: 818-880-8605