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CARDIOLOGY PRACTICE MEDICAL GROUP NPI 1629132535


NPI Profile

NPI: 1629132535
Provider Name: CARDIOLOGY PRACTICE MEDICAL GROUP
Classification:Specialist - 174400000X
Entity Type: Organization
Address:
17075 DEVONSHIRE ST STE 201
NORTHRIDGE, CA
ZIP 91325
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Phone: (818) 365-9595

CARDIOLOGY PRACTICE MEDICAL GROUP is a specialist in Northridge, 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. CARDIOLOGY PRACTICE MEDICAL GROUP NPI is 1629132535. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17075 DEVONSHIRE ST STE 201
NORTHRIDGE, CA
ZIP 91325-407
Phone: (818) 365-9595
Fax: (818) 365-8955

The provider's authorized official is Richard Fernando Pego .
The authorized official title is President and has the following contact phone number (818) 365-9595.

The enumeration date for this NPI number is 12/22/2006 and was last updated on 6/15/2010.


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
1174400000XSpecialistA33230CALIFORNIAYes

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
1222031992OTHERCALIFORNIABLUE SHIELD
2A27082MEDICARE UPINCALIFORNIA
3GR0091580MEDICAIDCALIFORNIA
4060067979OTHERCALIFORNIAMEDICARE RAILROAD
5W15511MEDICARE PINCALIFORNIA

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: 9/12/2021

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