MEDICARE: MANSHADI HEART INSTITUTE INC

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	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1225380603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANSHADI HEART INSTITUTE INC

Provider Business Mailing Address
First Line	:	PO BOX 4344
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-0344
Country	:	US
Telephone Number	:	209-944-5530
Fax Number	:	209-944-5990

Provider Business Practice Location Address
First Line	:	2633 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-4429
Country	:	US
Telephone Number	:	209-944-5530
Fax Number	:	209-944-5990

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAMIN MANSHADI
Credential	:	MD
Telephone Number	:	209-944-5530

Provider Enumeration Date	:	10/09/2012
Last Update Date	:	06/10/2026

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Directions to “MANSHADI HEART INSTITUTE INC ” Practice Location

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