Southland Cardiology Medical Group

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

A30933 Issued in CA

Legal business name

SOUTHLAND CARDIOLOGY MEDICAL GROUP

Practice address

399 E Highland Ave
Suite 307
San Bernardino, CA 92404-3808

Phone

(909) 881-7400

Fax

(909) 881-7404

NPI assigned

May 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sami Barham Nazzal, M.D.

Title

Partner

Phone

(909) 881-7400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anil Pitamber Punjabi, MD, DDS

  • Plastic Surgery Physician
  • Redlands, CA
  • NPI 1821194192
  NPD (past)
• Yaser A Slayyeh, M.D.

  • Specialist
  • San Bernardino, CA
  • NPI 1932174612
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1063624534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE",
            "address_2": "SUITE 307",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-881-7400",
            "fax_number": "909-881-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE",
            "address_2": "SUITE 307",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-881-7400",
            "fax_number": "909-881-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND CARDIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "NAZZAL",
        "authorized_official_first_name": "SAMI",
        "authorized_official_middle_name": "BARHAM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "909-881-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A30933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antoine O. Sourialle, D.D.S.
• Sarah Sourialle, DMD
• Larry E Southard, MA MFT
• Southern California Emergency Medicine
• Southland Anesthesia Consultants Inc
• Southland Dental Group Antoine Sourialle DDS Inc
• Bryan Lee Sowell, M.D.
• Sozo Recovery Residence
• Spark Link LLC
• Stacy Darnell Sparks

• Interventional Cardiology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.