Healthcare Provider Details

I. General information

NPI: 1376725333
Provider Name (Legal Business Name): PACIFIC CARDIOVASCULAR ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2007
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MACAW LN
SIMI VALLEY CA
93065-3152
US

IV. Provider business mailing address

2663 ELDEROAK LN
THOUSAND OAKS CA
91361-5347
US

V. Phone/Fax

Practice location:
  • Phone: 805-306-0304
  • Fax: 805-306-0102
Mailing address:
  • Phone: 805-306-0304
  • Fax: 805-306-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. BIKRAM J SONI
Title or Position: PRESIDENT
Credential: MD
Phone: 805-306-0304