FOOTHILL CARDIOLOGY MEDICAL GROUP INC. NPI 1255382545

NPI Information

NPI: 1255382545
Provider Name: FOOTHILL CARDIOLOGY MEDICAL GROUP, INC.

Former Legal Business Name: FOOTHILL CARDIOLOGY CALIFORNIA HEART MEDICAL GROUP INC.

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
625 S FAIR OAKS AVE STE 215
PASADENA, CA
ZIP 91105
Phone: (626) 793-4139
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FOOTHILL CARDIOLOGY MEDICAL GROUP, INC. is a cardiovascular disease internal medicine in Pasadena, 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. FOOTHILL CARDIOLOGY MEDICAL GROUP, INC. NPI is 1255382545. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Foothill Cardiology California Heart Medical Group Inc..

The provider's business location address is:

625 S FAIR OAKS AVE STE 215
PASADENA, CA
ZIP 91105-613
Phone: (626) 793-4139
Fax: (626) 793-4324

The provider's authorized official is Loretto Gonzalez .
The authorized official title is Cfo and has the following contact phone number (626) 793-2885.

The CLIA number assigned to this NPI record is 05D2131785 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 10/3/2022.

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	26766667	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	GR0041530	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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