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General NPI Number Information
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NPI Number | 1841598323
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY CLINIC OF NORTHERN CALIFORNIA
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 969 STORY RD SUITE 6066
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City | SAN JOSE
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State | CA
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Zip | 95122-2690
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Country | US
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Telephone | 408-293-5900
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Fax | 408-293-5901
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Provider Business Mailing Address
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Address Line | 969 STORY RD SUITE 6066
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City | SAN JOSE
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State | CA
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Zip | 95122-2690
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Country | US
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Telephone | 408-293-5900
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Fax | 408-293-5901
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Authorized Official
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Title or Position | CEO
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Name | DR. DAN VAN DANG
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Credential | M.D.
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Telephone | 408-293-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A90388
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License Number State | CA
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