BIG BEAR LAKE MEDICAL GROUP INC NPI 1174783989

NPI Information

NPI: 1174783989
Provider Name: BIG BEAR LAKE MEDICAL GROUP INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
41930 GARSTIN DR
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-6567
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BIG BEAR LAKE MEDICAL GROUP INC is a cardiovascular disease internal medicine in Big Bear Lake, CA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. BIG BEAR LAKE MEDICAL GROUP INC NPI is 1174783989. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

41930 GARSTIN DR
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-6567
Fax: (909) 866-7030

The provider's authorized official is Michael Norman .
The authorized official title is Physician and has the following contact phone number (909) 866-6567.

The enumeration date for this NPI number is 6/16/2008 and was last updated on 9/9/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	20A6319	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00AX63190	MEDICAID	CALIFORNIA
2	F83273	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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