MEDICARE: RELIABLE CARDIOVASCULAR SERVICES, 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	246X00000X	Cardiovascular Specialist/Technologist	52193	MN

General Provider Information

NPI Number	:	1336176221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIABLE CARDIOVASCULAR SERVICES, INC

Provider Business Mailing Address
First Line	:	1116 S. ARDMORE AVE # 5
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-3295
Country	:	US
Telephone Number	:	310-733-7763
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 S. ARDMORE AVE # 5
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-3295
Country	:	US
Telephone Number	:	310-733-7763
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRIAN SHIN
Credential	:
Telephone Number	:	310-733-7763

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/21/2022

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