Healthcare Provider Details

I. General information

NPI: 1245245877
Provider Name (Legal Business Name): CVI MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 GRANT RD
MOUNTAIN VIEW CA
94040-4315
US

IV. Provider business mailing address

2660 GRANT RD
MOUNTAIN VIEW CA
94040-4315
US

V. Phone/Fax

Practice location:
  • Phone: 650-969-8600
  • Fax: 650-969-2807
Mailing address:
  • Phone: 650-969-8600
  • Fax: 650-969-2807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberFNP22375
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberFNP22375
License Number StateCA

VIII. Authorized Official

Name: MS. JULIE WOODWORTH
Title or Position: CHIEF ADMINISTRATOR
Credential:
Phone: 650-969-8600