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General NPI Number Information
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NPI Number | 1023296092
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 5555 RESERVOIR DRIVE SUITE 209
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City | SAN DIEGO
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State | CA
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Zip | 92120
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Country | US
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Telephone | 619-582-2404
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Fax | 619-582-2915
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Provider Business Mailing Address
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Address Line | 5555 RESERVOIR DRIVE SUITE 209
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City | SAN DIEGO
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State | CA
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Zip | 92120
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Country | US
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Telephone | 619-582-2404
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Fax | 619-582-2915
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Authorized Official
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Title or Position | SECRETARY & TREASURER
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Name | PATRICIA ANN EVANS
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Credential |
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Telephone | 619-582-2780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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