MEDICARE: CARDIOLOGY OF SOUTHERN CALIFORNIA

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	G72122	CA

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
2	1649349820	OTHER	CA	INDIVIDUAL NPI#

General Provider Information

NPI Number	:	1164627295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY OF SOUTHERN CALIFORNIA

Provider Business Mailing Address
First Line	:	P. O. BOX 12607
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92039
Country	:	US
Telephone Number	:	619-470-7700
Fax Number	:	619-470-0996

Provider Business Practice Location Address
First Line	:	1845 E 12TH ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3719
Country	:	US
Telephone Number	:	619-470-7700
Fax Number	:	619-470-0996

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALBERT J SHARF
Credential	:	M.D.
Telephone Number	:	619-470-7700

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	06/23/2026

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