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T J FITZGIBBONS MD INC NPI 1861795965


NPI Information

NPI: 1861795965
Provider Name: T J FITZGIBBONS MD INC

Doing Business As: FITZGIBBONS VEIN CENTER

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
1245 WILSHIRE BLVD
SUITE 905
LOS ANGELES, CA
ZIP 90017
Phone: (213) 977-1211
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T J FITZGIBBONS MD INC is a vascular surgery surgery in Los Angeles, CA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. T J FITZGIBBONS MD INC NPI is 1861795965. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fitzgibbons Vein Center.

The provider's business location address is:

1245 WILSHIRE BLVD
SUITE 905
LOS ANGELES, CA
ZIP 90017-810
Phone: (213) 977-1211
Fax: (213) 977-0625

The provider's authorized official is Terrence J Fitzgibbons .
The authorized official title is Medical Director and has the following contact phone number (213) 977-1211.

The enumeration date for this NPI number is 12/10/2010 and was last updated on 7/29/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular SurgeryG32025CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A91399MEDICARE UPINCALIFORNIA
2G32025OTHERCALIFORNIASTATE OF CA LICENSE

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: 4/28/2024

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