CARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC NPI 1023296092

Internal Medicine (Cardiovascular Disease) in San Diego, CA

NPI 1023296092 Organization Internal Medicine Cardiovascular Disease CLIA Number 05D0980615 CLIA Certificate of Waiver

About CARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC

Cardiology Associates Medical Group Of East San Diego Inc is an internal medicine provider established in San Diego, California specializing in internal medicine (cardiovascular disease) . The NPI number of Cardiology Associates Medical Group Of East San Diego Inc is 1023296092 and was assigned on February 2008. The practitioner's primary taxonomy code is 207RC0000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. Cardiology Associates Medical Group Of East San Diego Inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Patricia Ann Evans (Secretary & Treasurer)

An internist like Cardiology Associates Medical Group Of East San Diego Inc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

The CLIA number of Cardiology Associates Medical Group Of East San Diego Inc is 05D0980615 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Cardiology Associates Medical Group Of East San Diego Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1023296092

Provider NameCARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC
Provider Location Address5555 RESERVOIR DRIVE SUITE 209 SAN DIEGO, CA 92120
Provider Mailing Address5555 RESERVOIR DRIVE SUITE 209 SAN DIEGO, CA 92120
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-01-2008
Last Update Date03-06-2008


Primary Taxonomy

Taxonomy Code207RC0000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationCardiovascular Disease
Taxonomy DescriptionAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Business Address

CARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC
5555 RESERVOIR DRIVE
SUITE 209
SAN DIEGO, CA
ZIP 92120
Phone: (619) 582-2404
Fax: (619) 582-2915

Get Directions


Mailing Address

CARDIOLOGY ASSOCIATES MEDICAL GROUP OF EAST SAN DIEGO INC
5555 RESERVOIR DRIVE
SUITE 209
SAN DIEGO, CA
ZIP 92120
Phone: (619) 582-2404
Fax: (619) 582-2915



Authorized Official

Authorized Official Name PATRICIA ANN EVANS
Authorized Official TitleSECRETARY & TREASURER
Authorized Official Phone(619) 582-2780

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1023296092 is:

CLIA Number05D0980615
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
ZZZ74366MEDICAID (05)CA
W015MEDICARE PIN (08)

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063476646DR. HABIB ANWAR MD MD
Individual
Urology5555 RESERVOIR DRIVE SUITE 206
SAN DIEGO, CA 92120
(619) 265-0911
1104998194MR. THOMAS R YOUNG MD
Individual
Internal Medicine (Interventional Cardiology)5555 RESERVOIR DRIVE SUITE 112
SAN DIEGO, CA 92120
(619) 287-7060
1548332539MR. RICHARD ALAN KATZ MD
Individual
Internal Medicine (Cardiovascular Disease)5555 RESERVOIR DRIVE SUITE 112
SAN DIEGO, CA 92120
(619) 287-7060
1477680551 LAURENCE GLENN YELLEN MD
Individual
Internal Medicine (Cardiovascular Disease)5555 RESERVOIR DRIVE SUITE 209
SAN DIEGO, CA 92120
(619) 582-2404
1154503373HAROLD COPANS MD INC
Organization
Internal Medicine (Cardiovascular Disease)5555 RESERVOIR DRIVE SUITE 112
SAN DIEGO, CA 92120
(619) 287-7060
1215058441 IRWIN GOLDSTEIN MD
Individual
Urology5555 RESERVOIR DRIVE SUITE 300
SAN DIEGO, CA 92120
(619) 987-7432
1801258843KARL SUN, M.D. INC.
Organization
Internal Medicine (Cardiovascular Disease)5555 RESERVOIR DRIVE SUITE 112
SAN DIEGO, CA 92120
(619) 287-7060

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.