NPIMap

Organization Active NPI

Santa Monica Preventive Cardiology Medical Group, Inc

  • Cardiovascular Disease Physician
  • Santa Monica, CA
National Provider Identifier
1164635470
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G26846 Issued in CA
Legal business name
SANTA MONICA PREVENTIVE CARDIOLOGY MEDICAL GROUP, INC
Doing business as
Richard L. Taw, Jr., M.D., Inc.
Practice address
2021 Santa Monica Blvd
Suite 212E
Santa Monica, CA 90404-2208
Phone
(310) 829-4327
Fax
(310) 453-4348
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Authorized official

Name
Mrs. Diane None Boylan
Title
Office Manager
Phone
(310) 829-4327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X G26846 CA Primary

Addresses

Primary practice location

2021 Santa Monica Blvd
Suite 212E
Santa Monica, CA 90404-2208

Mailing address

2021 Santa Monica Blvd
Suite 212E
Santa Monica, CA 90404-2208
Phone (310) 829-4327

Other names 1

  • Richard L. Taw, Jr., M.D., Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

2021 Santa Monica Blvd
Ste 212E
Santa Monica, CA 90404
Phone (310) 829-4327

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1164635470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 212E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4327",
            "fax_number": "310-453-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 212E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-4327",
            "fax_number": "310-453-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA PREVENTIVE CARDIOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "BOYLAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "NONE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-829-4327",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G26846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard L. Taw, Jr., M.D., Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.