CALIFORNIA INTERVENTIONAL MEDICAL GROUP


Address: 11601 Wilshire Blvd, 5th Floor, Los Angeles, CA 99025
Phone: 6307252737

CALIFORNIA INTERVENTIONAL MEDICAL GROUP (NPI# 1588917322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588917322
Entity Type Organization
Organization Name CALIFORNIA INTERVENTIONAL MEDICAL GROUP
Practice Address 11601 Wilshire Blvd
5th Floor
Los Angeles
CA 99025
Mailing Address 1901 Butterfield Rd.
Suite 220
Downers Grove
IL 60515-1279
Practice Telephone 6307252737
Mailing Telephone 6307252700
Mailing Fax Number 6307252783
Enumeration Date 2012-10-17
Last Update Date 2012-10-17
Authorized Official Name ROBERT LEE WORTHINGTON-KIRSCH (PHYSICIAN)
Authorized Official Telephone 6307252700
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 202K00000X Phlebology G88795 CA Allopathic & Osteopathic Physicians

Office Location

Street Address 11601 WILSHIRE BLVD
5TH FLOOR
City LOS ANGELES
State CA
Zip Code 99025

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1962460071 Fidelis Diagnostics, Inc. Specialist/Technologist, Other 11601 Wilshire Blvd, Suite 500, Los Angeles, CA 90025-0509 2006-05-01
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1770970238 Hamila Mossadeghi Clinic/Center 11601 Wilshire Blvd, 500, Los Angeles, CA 90025-0509 2015-04-22
1538298351 Ceth Ashen Psychologist 11601 Wilshire Blvd, 2410, Los Angeles, CA 90025-0509 2007-03-05
1336219526 Sung Hwan Bae Physical Therapist 11601 Wilshire Blvd, Ste 105, Los Angeles, CA 90025-0509 2006-11-08
1306941158 Carolyn Robertson Registered Nurse 11601 Wilshire Blvd, 5th Floor, Los Angeles, CA 90025-0509 2006-09-14
1841204484 Ethan Ezaki Physical Therapist 11601 Wilshire Blvd, Los Angeles, CA 90025-0509 2006-07-28
1467403709 Physiotherapy Associates Inc Clinic/Center 11601 Wilshire Blvd, Ste 105, Los Angeles, CA 90025-1700 2006-05-12

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1588640619 Patricia S Aspinwall Physical Therapist 1111 W Wellesley, Four Seasons Physical Therapy, Spokane, WA 99025-1274 2005-12-20
1689030546 Janelle Hicks Massage Therapist 13506 N Muzzy Rd, Newman Lake, WA 99025-8473 2016-01-07
1407915218 Karin Sue Brown Physical Therapy Assistant 5824 N Blue Skies St, Newman Lake, WA 99025-8623 2006-12-07
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1962058842 Janice Poe Pharmacist 6611 N Vincent Ln, Newman Lake, WA 99025-8662 2019-08-15
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Taxonomy Information

Taxonomy Code 202K00000X
Grouping Allopathic & Osteopathic Physicians
Classification Phlebology

Taxonomy Definition

Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism.
Notes: Source: American College of Phlebology 12/2006. www.phelbology.org [1/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: Training Programs, Fellowships, and/or Preceptorships: Certification exam is being established by the American Board of Phlebology. ACGME Accredited Residency Program Requirements: None

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1164699880 Vein Doctor Medical Group Inc. Phlebology 1945 E 17th St Ste 107, Santa Ana, CA 92705-6862 2008-05-12
1548789407 M'chae Hollowell Phlebology 405 W 5th St, Santa Ana, CA 92701-4599 2017-09-12
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1487188280 Stephen Hopkins Md Medical Corporation Phlebology 680 Guzzi Ln, Suite 103, Sonora, CA 95370-5288 2017-04-18
1295193357 Khateeb Vein Center Phlebology 44054 Margarita Rd, Suite 2, Temecula, CA 92592-2737 2016-02-04
1982955399 Eric Mowatt-larssen, Md, Inc Phlebology 977 Pacific St Ste B, Monterey, CA 93940-4400 2012-09-25
1720391527 Premier Vein Care Phlebology 3231 S Higuera St, San Luis Obispo, CA 93401-6924 2010-07-21
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Competitor

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City LOS ANGELES
Zip Code 99025

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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