Healthcare Provider Details

I. General information

NPI: 1568516623
Provider Name (Legal Business Name): CARDIOVASCULAR SPECIALTIES II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14624 SHERMAN WAY SUITE 406
VAN NUYS CA
91405-2241
US

IV. Provider business mailing address

14624 SHERMAN WAY SUITE 406
VAN NUYS CA
91405-2241
US

V. Phone/Fax

Practice location:
  • Phone: 818-989-9991
  • Fax: 818-373-7383
Mailing address:
  • Phone: 818-989-9991
  • Fax: 818-373-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number
License Number State

VIII. Authorized Official

Name: ORLANDO CANO
Title or Position: PRESIDENT
Credential: RCS, RCIS, FASE
Phone: 818-989-9991