Healthcare Provider Details

I. General information

NPI: 1164471868
Provider Name (Legal Business Name): LOS ANGELES CARDIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43723 20TH ST W
LANCASTER CA
93534-4784
US

IV. Provider business mailing address

1245 WILSHIRE BLVD STE 703
LOS ANGELES CA
90017-4807
US

V. Phone/Fax

Practice location:
  • Phone: 661-674-4222
  • Fax: 661-674-4220
Mailing address:
  • Phone: 213-977-7422
  • Fax: 213-250-9416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANA HUNT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 213-977-7422