JACK S VANGROW M.D. NPI 1467482174

NPI Information

NPI: 1467482174
Provider Name: JACK S VANGROW, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
1140 W. LA VETA AVE
SUITE # 640
ORANGE, CA
ZIP 92868
Phone: (714) 564-3300
Get Directions

Jack S Vangrow, M.D. is a cardiovascular disease internal medicine in Orange, CA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Jack S Vangrow, M.D. NPI is 1467482174. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1140 W. LA VETA AVE
SUITE # 640
ORANGE, CA
ZIP 92868-228
Phone: (714) 564-3300
Fax: (714) 564-3318

The NPI 1467482174 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 9/24/2012.

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
1	207RC0000X	Internal Medicine	Cardiovascular Disease	C29135	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AV805692	OTHER	CALIFORNIA	DEA
2	C29135	OTHER	CALIFORNIA	MEDICAL LICENSE
3	W13178	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS	FACILITY
4	GR0064090	MEDICAID	CALIFORNIA
5	A33841	MEDICARE UPIN	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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