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NPI Code Detail

MEDICARE: SOUTHERN CALIFORNIA HEART SPECIALISTS

MEDICARE: SOUTHERN CALIFORNIA HEART SPECIALISTS
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
1207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1396042289
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN CALIFORNIA HEART SPECIALISTS
Provider Business Mailing Address
First Line : 55 E CALIFORNIA BLVD
Second Line : THIRD FLOOR
City : PASADENA
State : CA
Zip : 91105-3954
Country : US
Telephone Number : 626-793-1227
Fax Number : 626-793-3794
Provider Business Practice Location Address
First Line : 224 S SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3521
Country : US
Telephone Number : 626-247-3220
Fax Number : 626-247-3223
Authorized Official
Title or Position : DIRECTOR OF BUSINESS OPERATIONS AND
Name : MRS. TRACY D BIGGLES
Credential :
Telephone Number : 626-793-1227
Provider Enumeration Date : 02/11/2011
Last Update Date : 02/11/2011

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Directions to “SOUTHERN CALIFORNIA HEART SPECIALISTS ” Practice Location

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