=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992115810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VINOD KANNARKAT MD INC., CARDIAC RHYTHM INSTITUTE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2014
-----------------------------------------------------
Last Update Date | 04/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 38780 TRADE CENTER DR
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93551-3641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-575-0705
-----------------------------------------------------
Fax | 661-575-0711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 38780 TRADE CENTER DR
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93551-3641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-575-0705
-----------------------------------------------------
Fax | 661-575-0711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | VINOD T KANNARKAT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 661-575-0705
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------