MEDICARE: MANUEL E SIPOWICZ MD INC ET AL PTR CARDIOVASCULAR CONSULTANTS OF SO CA

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	W10369	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669463998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANUEL E SIPOWICZ MD INC ET AL PTR CARDIOVASCULAR CONSULTANTS OF SO CA

Provider Business Mailing Address
First Line	:	3055 W ORANGE AVE STE 203
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3154
Country	:	US
Telephone Number	:	714-220-0263
Fax Number	:	714-952-2968

Provider Business Practice Location Address
First Line	:	3055 W ORANGE AVE STE 203
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3154
Country	:	US
Telephone Number	:	714-220-0263
Fax Number	:	714-952-2968

Authorized Official
Title or Position	:	CO-OWNER
Name	:	NAMI MORADI
Credential	:	MD
Telephone Number	:	310-770-7396

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	12/24/2025

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