=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972229821
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARDIO-VASCULAR ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2022
-----------------------------------------------------
Last Update Date | 08/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11760 CENTRAL AVE STE 204
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-1909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-632-1225
-----------------------------------------------------
Fax | 909-632-1265
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27053 REDRIVER DR
-----------------------------------------------------
City | MENIFEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92585-8888
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-632-1225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | JAMES M FEENEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 909-632-1225
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------