Healthcare Provider Details

I. General information

NPI: 1700821691
Provider Name (Legal Business Name): PACIFIC CARDIOVASCULAR ASSOCIATES MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CREEK RD
IRVINE CA
92604-4724
US

IV. Provider business mailing address

35 CREEK RD
IRVINE CA
92604-4724
US

V. Phone/Fax

Practice location:
  • Phone: 714-445-0220
  • Fax: 714-445-0245
Mailing address:
  • Phone: 714-445-0220
  • Fax: 714-445-0245

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: DAVID MICHAEL GOBLE
Title or Position: PRESIDENT, OWNER
Credential:
Phone: 714-389-1843