MEDICARE: GREATER LOS ANGELES CARDIOLOGY 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

General Provider Information

NPI Number	:	1447343413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER LOS ANGELES CARDIOLOGY MEDICAL GROUP

Provider Business Mailing Address
First Line	:	711 W COLLEGE ST STE 208
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1093
Country	:	US
Telephone Number	:	323-741-0135
Fax Number	:	323-741-0157

Provider Business Practice Location Address
First Line	:	711 W COLLEGE ST STE 208
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1093
Country	:	US
Telephone Number	:	323-741-0135
Fax Number	:	323-741-0157

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER CHU
Credential	:	MD
Telephone Number	:	213-673-1880

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	03/10/2026

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