Healthcare Provider Details
I. General information
NPI: 1285228056
Provider Name (Legal Business Name): LOS ANGELES CARDIOVASCULAR CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2021
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 BELLEFONTAINE ST STE 302
PASADENA CA
91105-3132
US
IV. Provider business mailing address
281 E COLORADO BLVD # 751
PASADENA CA
91101-1903
US
V. Phone/Fax
- Phone: 626-427-7041
- Fax: 323-336-9319
- Phone: 323-448-0334
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SOHA
AHMAD
Title or Position: CEO AND OWNER OF PRACTICE
Credential: MD
Phone: 323-448-0334