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General NPI Number Information
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NPI Number | 1467444711
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Entity Type | Organization
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Legal Business Name | NORTHERN CALIFORNIA CARDIOLOGY ASSOCIATES MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 5301 F ST #117
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City | SACRAMENTO
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State | CA
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Zip | 95819-3226
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Country | US
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Telephone | 916-733-1788
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Fax | 916-733-1787
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Provider Business Mailing Address
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Address Line | 1330 21ST STREET #201 C/O MIDTOWN FINANCIAL
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City | SACRAMENTO
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State | CA
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Zip | 95811-4231
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Country | US
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Telephone | 916-561-6848
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Fax | 916-447-9210
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM R. VETTER
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Credential | M.D.
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Telephone | 916-733-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 207RC0001X
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 207R10011X
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 207UN0901X
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 207RC0000X
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License Number State | CA
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