Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southern California Vein and Aesthetics LLC

Organization Vascular Surgery Physician · NPI 1720935505

Southern California Vein and Aesthetics LLC provides Vascular Surgery Physician services in Riverside, California. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6780 Indiana Ave Ste 110
Riverside, CA 92506-4284
Phone: (951) 213-9269
Fax: (951) 213-6483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X

Record details

NPI number1720935505
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Tahir — Ceo · (760) 515-6260
NPI enumeratedMarch 11, 2026
Last updated in NPPESMarch 11, 2026
Certification dateMarch 11, 2026
Mailing address18092 Wika Rd Ste 220, Apple Valley, CA 92307-2132

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