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General NPI Number Information
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NPI Number | 1619028149
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Entity Type | Organization
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Legal Business Name | SANTA CLARITA CARDIOLOGY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 23928 LYONS AVE STE 101
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City | NEWHALL
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State | CA
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Zip | 91321-2452
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Country | US
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Telephone | 661-255-8321
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Fax | 661-255-0338
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Provider Business Mailing Address
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Address Line | 23928 LYONS AVE STE 101
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City | NEWHALL
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State | CA
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Zip | 91321-2452
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Country | US
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Telephone | 661-255-8321
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Fax | 661-255-0338
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROLD ETON QUAN
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Credential | M.D.
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Telephone | 661-255-8321
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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 | CORP#2878253
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License Number State | CA
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