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SAN FRANCISCO PENINSULA CARDIOVASCULAR MEDICAL GRP INC NPI 1821160771


NPI Information

NPI: 1821160771
Provider Name: SAN FRANCISCO PENINSULA CARDIOVASCULAR MEDICAL GRP INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 05D2069498

Address:
1500 SOUTHGATE AVE
SUITE 202
DALY CITY, CA
ZIP 94015
Phone: (650) 991-3200
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SAN FRANCISCO PENINSULA CARDIOVASCULAR MEDICAL GRP INC is a cardiovascular disease internal medicine in Daly City, 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. SAN FRANCISCO PENINSULA CARDIOVASCULAR MEDICAL GRP INC NPI is 1821160771. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1500 SOUTHGATE AVE
SUITE 202
DALY CITY, CA
ZIP 94015
Phone: (650) 991-3200
Fax: (650) 991-1153

The provider's authorized official is Colman Ryan .
The authorized official title is President and has the following contact phone number (650) 991-1085.

The CLIA number assigned to this NPI record is 05D2069498 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 8/22/2020.


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
1207RC0000XInternal MedicineCardiovascular DiseaseC32329CALIFORNIANo
2207RC0000XInternal MedicineCardiovascular DiseaseA26490CALIFORNIAYes

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
1ZZZ75309ZMEDICAIDCALIFORNIA

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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