SHADELANDS ENDOVASCULAR LLC NPI 1245620954

NPI Information

  • NPI: 1245620954
  • Provider Name: SHADELANDS ENDOVASCULAR, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 460 N WIGET LN STE B
    WALNUT CREEK, CA
    ZIP 94598
  • Phone: (925) 627-3495

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NPI Details

SHADELANDS ENDOVASCULAR, LLC is an ambulatory surgical clinic center in Walnut Creek, CA. SHADELANDS ENDOVASCULAR, LLC NPI is 1245620954. The provider is registered as an organization entity type.

The provider's business location address is:

460 N WIGET LN STE B
WALNUT CREEK, CA
ZIP 94598-408
Phone: (925) 627-3495
Fax: (925) 891-4322

The provider's authorized official is Inez Wondeh .
The authorized official title is Coo and has the following contact phone number (925) 378-4500.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist (HCPCS:36902)
  • Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist (HCPCS:36903)
  • Insertion of needle and/or tube into hemodialysis circuit with review by radiologist (HCPCS:36901)
  • Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube (HCPCS:36905)

The enumeration date for this NPI number is 2/2/2015 and was last updated on 4/4/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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