Healthcare Provider Details
I. General information
NPI: 1003547340
Provider Name (Legal Business Name): HEART AND VASCULAR CENTERS OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2022
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1233 PLUMAS ST
YUBA CITY CA
95991-3410
US
IV. Provider business mailing address
8787 COMPLEX DR STE 202
SAN DIEGO CA
92123-1451
US
V. Phone/Fax
- Phone: 530-715-2900
- Fax:
- Phone:
- 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 | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
MICHELLE
SALLEE
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 619-807-1981