California Vascular & Interventional – Vascular & Interventional Radiology Physician, NPI 1053975847
Vascular & Interventional Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for California Vascular & Interventional
27699 Jefferson Ave Ste 305
Temecula, CA 925902615
Phone: (323) 546-7993
Type: Location
133 N Praire Ave
Ste C
Inglewood, CA 90301
Phone: (323) 546-7993
Type: Location
7634 Girard Ave
LA Jolla, CA 920374420
Phone: (323) 546-7993
Type: Location
26081 Merit Cir
Laguna Hills, CA 926537017
Phone: (323) 546-7993
Type: Location
255 E Bonita Ave # 201
Pomona, CA 917671923
Phone: (323) 546-7993
Type: Location
8500 Wilshire Blvd Ste 518
Beverly Hills, CA 902113111
Phone: (310) 409-4114
Fax: (855) 853-7268
Type: Location
8549 WILSHIRE BLVD # 14157
BEVERLY HILLS, CA 902113104
Phone: (323) 546-7993
Fax: (213) 800-0806
Type: Mailing
145, North Robertson Boulevard, Beverly Hills, Los Angeles County, California, 90211, United States
BEVERLY HILLS, CA 902112103
Phone: (310) 409-4114
Fax: (213) 800-0806
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-10-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (194 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20191007002926 | O | Clinic/Group Practice | CA | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92590)
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