PACIFIC HEART AND VASCULAR MEDICAL GROUP - NPI 1790712990

Q: What is Pacific Heart And Vascular Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

On this page

About Pacific Heart And Vascular Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC HEART AND VASCULAR MEDICAL GROUP (NPI 1790712990) is a healthcare organization registered as a cardiovascular disease in Lodi, California and active in the NPI registry since June 2006. The organization lists Katherine Bohna, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1790712990

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NamePACIFIC HEART AND VASCULAR MEDICAL GROUP

Location Address845 S FAIRMONT AVE, SUITE 11Lodi, CA 95240-5113

Mailing Address1801 E March Ln, Suite D400Stockton, CA 95210-6629 · (209) 464-3615 · Fax (209) 464-1311

Phone(209) 334-0651

Fax(209) 334-5013

Organization SubpartNo

Authorized OfficialKatherine BohnaSupervisor · (209) 464-3615

Enumeration DateJune 26, 2006

Last NPPES UpdateMarch 2, 2020

NPPES CertifiedMarch 2, 2020

✔ NPI 1790712990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in CA · FNP33233

Definition

An 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.

845 S FAIRMONT AVE, Lodi, CA 95240

Open in Google Maps ↗

Other Identifiers 3

OtherZZZ59847ZCA · Bc/bs Grp Provider #

Other060057321CA · Railroad Medicare Group #

MedicaidGR0086060CA

Group Practice 1

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

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONNA MARLANE BENNETT FNP

Nurse Practitioner (Occupational Health)

845 S FAIRMONT AVE, #8
LODI, CA 95240

San Joaquin County (209) 339-7633

CATHLEEN MARIE LIGMAN MD

Specialist

845 S FAIRMONT AVE, SUITE 2
LODI, CA 95240

San Joaquin County (209) 367-1878

MANI MAHDYOON, M.D., A PROFESSIONAL CORPORATION

Internal Medicine

845 S FAIRMONT AVE, SUITE #5
LODI, CA 95240

San Joaquin County (209) 366-2360

DR. RAJEEV SHUKLA MD

Internal Medicine

845 S FAIRMONT AVE, SUITE 1
LODI, CA 95240

San Joaquin County (209) 224-5385

DR. LINGAMURTHY RAVI M.D.

Hospitalist

845 S FAIRMONT AVE, SUITE 8
LODI, CA 95240

San Joaquin County (209) 339-7625

ZIN SURGICAL ASSOCIATES INC

Specialist

845 S FAIRMONT AVE, #2
LODI, CA 95240

San Joaquin County (209) 367-1878

BROOKE TIRADO

Physical Therapist

845 S FAIRMONT AVE
LODI, CA 95240

San Joaquin County (209) 334-3411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Heart And Vascular Medical Group's NPI number?

The NPI number for Pacific Heart And Vascular Medical Group is 1790712990. It was assigned to this organization in the NPPES registry on June 26, 2006.

Where is Pacific Heart And Vascular Medical Group located?

Pacific Heart And Vascular Medical Group is located at 845 S Fairmont Ave Suite 11, Lodi, CA 95240. The listed phone number is (209) 334-0651.

What is Pacific Heart And Vascular Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Pacific Heart And Vascular Medical Group was last updated on March 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.