1427307230 NPI number — RELIANCE CARDIAC CARE, INC.

Table of content: (NPI 1427307230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427307230 NPI number — RELIANCE CARDIAC CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RELIANCE CARDIAC CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427307230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 W GARVEY AVE
Provider Second Line Business Mailing Address:
# 154-B
Provider Business Mailing Address City Name:
MONTEREY PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91754-7430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-277-8888
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 W EULALIA ST
Provider Second Line Business Practice Location Address:
SUITE 311
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91204-2849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-550-7533
Provider Business Practice Location Address Fax Number:
818-550-7532
Provider Enumeration Date:
09/07/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
760-977-0778

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GP873A . This is a "MEDICARE PTAN #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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