Healthcare Provider Details

I. General information

NPI: 1548780497
Provider Name (Legal Business Name): ADVANCED CARDIOLOGY & VASCULAR SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N 5TH AVE STE 303
ARCADIA CA
91006-3711
US

IV. Provider business mailing address

51 N 5TH AVE STE 303
ARCADIA CA
91006-3711
US

V. Phone/Fax

Practice location:
  • Phone: 626-576-1800
  • Fax: 626-576-1808
Mailing address:
  • Phone: 626-576-1800
  • Fax: 626-576-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HSIN YI GRACE HUANG
Title or Position: PRESIDENT
Credential: MD
Phone: 626-576-1800