NPI 1033614706

Ellison Medical Group Vein Treatment Center

Organisation Specialist San Diego, CA

Practice location

Address: 5330 Carroll Canyon Rd STE 140, San Diego, CA 92121-3758
Phone: (669) 201-0667
Fax: (818) 616-6046
Mailing address: 244 Madison Ave STE 141, New York, NY 10016-2817

Authorised official

Name: Michael Nguyen
Title: Owner
Phone: (332) 282-5622

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1033614706
Entity type: Organization
NPI issued: 26 Mar 2018
Record last updated: 24 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.