Healthcare Provider Details

I. General information

NPI: 1669530176
Provider Name (Legal Business Name): CARDIO-PULMONARY ASSOCIATES MEDICAL GROUP INC A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CASS ST STE B1
MONTEREY CA
93940-4515
US

IV. Provider business mailing address

PO BOX 3888
SAN RAMON CA
94583-8888
US

V. Phone/Fax

Practice location:
  • Phone: 831-646-8570
  • Fax: 831-646-5435
Mailing address:
  • Phone: 925-718-6622
  • Fax: 925-626-4666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HANS POGGEMEYER
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 831-646-8570