MEDICARE: HIGH DESERT CARDIAC & MEDICAL CLINIC 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	174400000X	Specialist	G66022	CA

General Provider Information

NPI Number	:	1548500192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH DESERT CARDIAC & MEDICAL CLINIC INC

Provider Business Mailing Address
First Line	:	17868 US HIGHWAY 18
Second Line	:	#102
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-946-5177
Fax Number	:	760-946-5133

Provider Business Practice Location Address
First Line	:	17868 US HIGHWAY 18
Second Line	:	#102
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-946-5177
Fax Number	:	760-946-5133

Authorized Official
Title or Position	:	OWNER/ CARDIOLOGIST
Name	:	DR. SIVA ARUNASALAM
Credential	:	MD
Telephone Number	:	760-241-2270

Provider Enumeration Date	:	02/19/2013
Last Update Date	:	05/25/2023

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