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General NPI Number Information
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NPI Number | 1902465792
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Entity Type | Organization
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Legal Business Name | PACIFIC HEART & VASCULAR
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 1234 W. CHAPMAN AVE STE #101
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City | ORANGE
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State | CA
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Zip | 92868-2862
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Country | US
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Telephone | 714-532-6713
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Fax | 714-532-1169
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Provider Business Mailing Address
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Address Line | 1234 W. CHAPMAN AVE STE #101
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City | ORANGE
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State | CA
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Zip | 92868-2862
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Country | US
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Telephone | 714-532-6713
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Fax | 714-532-1169
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. SENDHIL K KRISHNAN
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Credential | M.D.
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Telephone | 813-368-8814
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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 |
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License Number State |
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