Advanced Cardiothoracic Surgery Medical Group, Inc.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

G72926 Issued in CA

Legal business name

ADVANCED CARDIOTHORACIC SURGERY MEDICAL GROUP, INC.

Practice address

1245 Wilshire Blvd
Suite 606
Los Angeles, CA 90017-4810

Phone

(213) 483-1055

Fax

(213) 483-1418

NPI assigned

Aug 19, 2005

Organization subpart

No

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

Authorized official

Name

Ali Gheissari, M.D.

Title

President

Phone

(213) 483-1055

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1104818715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-483-1055",
            "fax_number": "213-483-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-483-1055",
            "fax_number": "213-483-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARDIOTHORACIC SURGERY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "GHEISSARI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-483-1055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G72926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advance Health Integrative Medicine
• Advance Specialty Care, LLC
• Advance Transportation LLC
• Advanced California Dental Clinic Inc
• Advanced Cardiac Monitoring, Inc.
• Advanced Care Prosthetics and Orthotics
• Advanced Caring Podiatry PC
• Advanced Diagnostic & Management
• Advanced Diagnostic Services Inc.
• Advanced Diagnostics

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.