MANA VASCULAR CLINIC, PLLC – NPI #1386121580
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

MANA VASCULAR CLINIC, PLLC is a surgeon located in GLENDALE, AZ. NPPES has assigned the NPI number 1386121580 to MANA VASCULAR CLINIC, PLLC on July 20, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was last updated on Aug 11, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MANA VASCULAR CLINIC, PLLC below.

NPI Profile for
MANA VASCULAR CLINIC, PLLC

NPI Number
1386121580
Enumeration Date

(about 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MANA VASCULAR CLINIC, PLLC
Primary location
18555 N 79TH AVE STE B101
GLENDALE, AZ 85308-8372
Phone: (520) 979-7095 Fax: (623) 594-2252
Mailing address
14780 W MOUNTAIN VIEW BLVD STE 120
SURPRISE, AZ 85374-7280
Phone: (520) 979-7095 Fax:
Organization Subpart
No
Authorized Official
LANNERY LAUVAO
OWNER
Phone: (520) 979-7095
Updated
Certification Date
Aug 11, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)
261QM1300X
- Clinic/Center / Multi-Specialty

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.