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NPI Code Detail

MEDICARE: MEMORIAL CARDIOLOGY MEDICAL GROUP INC

MEDICARE: MEMORIAL CARDIOLOGY MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine

General Provider Information

NPI Number : 1811389547
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEMORIAL CARDIOLOGY MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 2898 LINDEN AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-1627
Country : US
Telephone Number : 562-595-8671
Fax Number : 562-490-2015
Provider Business Practice Location Address
First Line : 2725 E BROADWAY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-5431
Country : US
Telephone Number : 562-434-4494
Fax Number : 562-434-8324
Authorized Official
Title or Position : PRESIDENT
Name : DR. SERGE M TOBIAS
Credential : M.D
Telephone Number : 562-595-8671
Provider Enumeration Date : 03/04/2015
Last Update Date : 03/04/2015

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