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Empire Vein & Vascular Specialists fax number

(760) 423-6273

Physician Referrals

Used for: Physician referral form submission for vascular care

Fax destination details

Department
Physician Referrals
Purpose
Physician referral form submission for vascular care
Form
Physician Referral Form — Empire Vein & Vascular Specialists Referral Form
Address
La Quinta: 79440 Corporate Center Dr., Suite 119, La Quinta, CA 92253; Palm Springs: 1100 North Palm Canyon Dr., Suite 107, Palm Springs, CA 92262; Rancho Mirage: 71780 San Jacinto Dr., Building I, Rancho Mirage, CA 92270; Victorville: 15095 Amargosa Rd, Suite 101, Victorville, CA 92394; Ontario: 3333 Concours St., Building 6, Suite 100, Ontario, CA 91764; Riverside: 6848 Magnolia Ave., Suite 125, Riverside, CA 92506
Voice phone
1-800-827-4267

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fill out the physician referral form and fax to 760-423-6273. The form can be downloaded from the Empire Vein & Vascular Specialists Physician Referrals page.

Review official form instructions

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