Healthcare Provider Details

I. General information

NPI: 1245314749
Provider Name (Legal Business Name): CARDIOLOGY CONSULTANTS OF NAPA VALLEY INC A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 VILLA LN SUITE 2
NAPA CA
94558-6417
US

IV. Provider business mailing address

3443 VILLA LN SUITE 2
NAPA CA
94558-6417
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-8280
  • Fax: 707-253-7023
Mailing address:
  • Phone: 707-253-8280
  • Fax: 707-253-7023

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 Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAUREEN BARDWELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 707-253-8280