Healthcare Provider Details

I. General information

NPI: 1336176221
Provider Name (Legal Business Name): RELIABLE CARDIOVASCULAR SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 S. ARDMORE AVE # 5
LOS ANGELES CA
90006-3295
US

IV. Provider business mailing address

1116 S. ARDMORE AVE # 5
LOS ANGELES CA
90006-3295
US

V. Phone/Fax

Practice location:
  • Phone: 310-733-7763
  • Fax:
Mailing address:
  • Phone: 310-733-7763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number52193
License Number StateMN

VIII. Authorized Official

Name: BRIAN SHIN
Title or Position: PRESIDENT
Credential:
Phone: 310-733-7763