MEDICARE: ADVANCED CARDIOVASCULAR INTERPRETATIONS MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033174552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARDIOVASCULAR INTERPRETATIONS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	PO BOX 2311
Second Line	:
City	:	CHATSWORTH
State	:	CA
Zip	:	91313-2311
Country	:	US
Telephone Number	:	818-501-5686
Fax Number	:	805-578-8950

Provider Business Practice Location Address
First Line	:	15031 RINALDI ST
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1207
Country	:	US
Telephone Number	:	818-898-4603
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALAN SHIENER
Credential	:	MD
Telephone Number	:	818-501-5686

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	06/11/2008

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