Renaissance Asthetic Laser and Vein Institute, A Medical Corporation
NPI 1730258187ActiveOrganization· Surgery, Vascular Surgery· Thousand Oaks, CA
Surgery, Vascular Surgery in Thousand Oaks, California, registered in NPPES in November 2006. The authorized official on file is Gholam Reza Mohammadzadeh, MD, Owner/President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1730258187 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 7, 2006 |
| Last updated in NPPES | Aug 23, 2024 |
| Certified by provider | Aug 23, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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