Healthcare Provider Details

I. General information

NPI: 1003087313
Provider Name (Legal Business Name): DOWNEY CARDIO- MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11544 DOWNEY AVE
DOWNEY CA
90241-4955
US

IV. Provider business mailing address

11544 DOWNEY AVE
DOWNEY CA
90241-4955
US

V. Phone/Fax

Practice location:
  • Phone: 562-947-2464
  • Fax:
Mailing address:
  • Phone: 562-947-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberW007
License Number StateCA

VIII. Authorized Official

Name: ANANJIT SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 562-947-2464