Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tri-State Vascular Group, PLLC

Organization Vascular Surgery Physician · NPI 1366993818

Tri-State Vascular Group, PLLC is a Vascular Surgery Physician in Needles, California. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1401 Bailey Ave Bldg A
Needles, CA 92363-3103
Phone: (960) 590-0155
Fax: (760) 326-7170
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1366993818
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wantzy Cooper — Owner/Member Manager · (760) 590-0155
NPI enumeratedOctober 19, 2016
Last updated in NPPESApril 8, 2024
Certification dateApril 8, 2024
Mailing addressPo Box 9893, Fort Mohave, AZ 86427-9893