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General NPI Number Information
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NPI Number | 1205983046
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA HEART CENTERS INC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 711 W COLLEGE ST SUITE 300
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City | LOS ANGELES
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State | CA
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Zip | 90012-1163
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Country | US
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Telephone | 626-308-3800
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Fax | 626-308-1899
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Provider Business Mailing Address
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Address Line | 506 W VALLEY BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776
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Country | US
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Telephone | 626-308-3800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STANLEY LAU
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Credential |
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Telephone | 626-608-3800
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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 | A46648
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License Number State | CA
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