=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568898575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROHRA CARDIOVASCULAR INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2013
-----------------------------------------------------
Last Update Date | 09/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2485 HIGH SCHOOL AVE 103
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94520-1819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-233-4480
-----------------------------------------------------
Fax | 925-233-4490
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2485 HIGH SCHOOL AVE 103
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94520-1819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-233-4480
-----------------------------------------------------
Fax | 925-233-4490
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SRIKRISHIN ROHRA
-----------------------------------------------------
Credential | M.D., F.A.C.C.
-----------------------------------------------------
Telephone | 925-233-4480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | A50848
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------