MODERN VASCULAR INSTITUTE LLC NPI 1619407442

NPI Information

  • NPI: 1619407442
  • Provider Name: MODERN VASCULAR INSTITUTE LLC
  • Classification: Radiology - 2085R0204X
  • Specialization: Vascular & Interventional Radiology
  • Entity Type: Organization
  • Address: 535 E MCKELLIPS RD STE 115
    MESA, AZ
    ZIP 85203
  • Phone: (818) 262-6423

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NPI Details

MODERN VASCULAR INSTITUTE LLC is a vascular and interventional radiology radiology in Mesa, AZ. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. MODERN VASCULAR INSTITUTE LLC NPI is 1619407442. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

535 E MCKELLIPS RD STE 115
MESA, AZ
ZIP 85203
Phone: (818) 262-6423

The provider's authorized official is Yury Gampel .
The authorized official title is Owner and has the following contact phone number (818) 880-8605.

The enumeration date for this NPI number is 6/14/2017 and was last updated on 7/11/2018.

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
1207RI0011XInternal MedicineInterventional CardiologyNo
2213E00000XPodiatristNo
3207Q00000XFamily MedicineNo
4207RC0000XInternal MedicineCardiovascular DiseaseNo
52085R0204XRadiologyVascular & Interventional RadiologyYes

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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