MARA VASCULAR SURGERY CENTER INC. NPI 1720956501

NPI Information

  • NPI: 1720956501
  • Provider Name: MARA VASCULAR SURGERY CENTER INC.
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 1101 BAYSIDE DR STE 100
    CORONA DEL MAR, CA
    ZIP 92625
  • Phone: (747) 777-3188

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NPI Details

MARA VASCULAR SURGERY CENTER INC. is an ambulatory surgical clinic center in Corona Del Mar, CA. MARA VASCULAR SURGERY CENTER INC. NPI is 1720956501. The provider is registered as an organization entity type.

The provider's business location address is:

1101 BAYSIDE DR STE 100
CORONA DEL MAR, CA
ZIP 92625-754
Phone: (747) 777-3188
Fax: (747) 777-4110

The provider's authorized official is Ramsess Khosravi .
The authorized official title is Owner and has the following contact phone number (323) 770-9607.

The enumeration date for this NPI number is 10/24/2025 and was last updated on 11/12/2025.

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: 11/21/2025

NPI Synchronization or Removal

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