MEDICARE: CARDIOTHORACIC SURGICAL ASSOC.,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	G77973	CA

General Provider Information

NPI Number	:	1841251907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOTHORACIC SURGICAL ASSOC.,INC.

Provider Business Mailing Address
First Line	:	1900 MOWRY AVE
Second Line	:	401
City	:	FREMONT
State	:	CA
Zip	:	94538-1722
Country	:	US
Telephone Number	:	510-796-4401
Fax Number	:	510-796-2943

Provider Business Practice Location Address
First Line	:	1900 MOWRY AVE
Second Line	:	410
City	:	FREMONT
State	:	CA
Zip	:	94538-1722
Country	:	US
Telephone Number	:	510-796-4401
Fax Number	:	510-796-2943

Authorized Official
Title or Position	:	M.D./PRESIDENT/OWNER
Name	:	DR. ADAM L HARMON
Credential	:	M.D.
Telephone Number	:	510-796-4401

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	08/22/2020

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