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PACIFIC PEDIATRIC CARDIOLOGY MED GRP INC NPI 1396720371


NPI Information

NPI: 1396720371
Provider Name: PACIFIC PEDIATRIC CARDIOLOGY MED GRP INC
Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

Address:
50 W BELLEFONTAINE ST
SUITE 405
PASADENA, CA
ZIP 91105
Phone: (626) 796-9259
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PACIFIC PEDIATRIC CARDIOLOGY MED GRP INC is a pediatric cardiology pediatrics in Pasadena, CA. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. PACIFIC PEDIATRIC CARDIOLOGY MED GRP INC NPI is 1396720371. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

50 W BELLEFONTAINE ST
SUITE 405
PASADENA, CA
ZIP 91105-132
Phone: (626) 796-9259
Fax: (626) 449-8560

The provider's authorized official is William R Vincent .
The authorized official title is President and has the following contact phone number (626) 796-9259.

The enumeration date for this NPI number is 12/13/2005 and was last updated on 7/24/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0202XPediatricsPediatric CardiologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0086740MEDICAIDCALIFORNIA
2ZZZ609882OTHERCALIFORNIABCBS
3W14906MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

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: 4/28/2024

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