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NPI Code Detail

MEDICARE: SAN BERNARDINO CARDIO CARE

MEDICARE: SAN BERNARDINO CARDIO CARE
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
1343900000XNon-emergency Medical Transport (VAN)CA
2261Q00000XClinic/CenterCA

General Provider Information

NPI Number : 1922241215
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN BERNARDINO CARDIO CARE
Provider Business Mailing Address
First Line : 5231 ONAKNOLL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1041
Country : US
Telephone Number : 323-294-8123
Fax Number :
Provider Business Practice Location Address
First Line : 5231 ONAKNOLL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1041
Country : US
Telephone Number : 323-793-9183
Fax Number :
Authorized Official
Title or Position : CEO
Name : MRS. JACQUELYN THOMPSON
Credential :
Telephone Number : 323-294-8123
Provider Enumeration Date : 04/16/2009
Last Update Date : 05/14/2010

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Directions to “SAN BERNARDINO CARDIO CARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.