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THE HEART CENTER OF SAN DIEGO MEDICAL GROUP INC NPI 1477754091


NPI Information

NPI: 1477754091
Provider Name: THE HEART CENTER OF SAN DIEGO MEDICAL GROUP, INC

Doing Business As: GROSSMONT HEART CENTER MEDICAL GROUP, INC

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
8851 CENTER DR STE 312
LA MESA, CA
ZIP 91942
Phone: (619) 667-0708
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THE HEART CENTER OF SAN DIEGO MEDICAL GROUP, INC is a specialist in La Mesa, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. THE HEART CENTER OF SAN DIEGO MEDICAL GROUP, INC NPI is 1477754091. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Grossmont Heart Center Medical Group, Inc.

The provider's business location address is:

8851 CENTER DR STE 312
LA MESA, CA
ZIP 91942-050
Phone: (619) 667-0708

The provider's authorized official is Jack Stuart Madowitz .
The authorized official title is Physician and has the following contact phone number (619) 667-0708.

The enumeration date for this NPI number is 5/30/2007 and was last updated on 10/16/2007.


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
1174400000XSpecialistG040881CALIFORNIAYes

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
1A48385MEDICARE UPINCALIFORNIA
2W14888MEDICARE 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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