Healthcare Provider Details

I. General information

NPI: 1558121814
Provider Name (Legal Business Name): CARDIOVASCULAR SPECIALISTS OF REDLANDS AND THE INLAND EMPIRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

IV. Provider business mailing address

1752 E LUGONIA AVE STE 117-1124
REDLANDS CA
92374-2730
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-5500
  • Fax:
Mailing address:
  • Phone: 909-499-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: RAMDAS G PAI
Title or Position: OWNER
Credential: MD
Phone: 909-499-3050