Healthcare Provider Details

I. General information

NPI: 1982802690
Provider Name (Legal Business Name): CALIFORNIA HEART AND LUNG SURGERY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 S BEVERLY DR #444
BEVERLY HILLS CA
90212-3807
US

IV. Provider business mailing address

6253 HOLLYWOOD BLVD APT 1108
HOLLYWOOD CA
90028-8261
US

V. Phone/Fax

Practice location:
  • Phone: 949-588-2190
  • Fax: 949-588-2199
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA72254
License Number StateCA

VIII. Authorized Official

Name: ALEXANDER MARMUREANU
Title or Position: PRESIDENT
Credential: MD
Phone: 949-588-2190