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General NPI Number Information
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NPI Number | 1518054048
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Entity Type | Organization
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Legal Business Name | DIAMOND BAR CARDIOVASCULAR MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 654 N DIAMOND BAR BLVD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1037
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Country | US
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Telephone | 909-396-8228
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Fax | 909-396-8227
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Provider Business Mailing Address
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Address Line | 654 N DIAMOND BAR BLVD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1037
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Country | US
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Telephone | 909-396-8228
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Fax | 909-396-8227
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PINGCHU YANG
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Credential |
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Telephone | 909-396-8228
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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 | A44181
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License Number State | CA
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