Organization Active NPI

Cardio Vascular Health and Nutrition

  • Cardiovascular Disease Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1174029631
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIO VASCULAR HEALTH AND NUTRITION
Practice address
10535 Foothill Blvd Ste 365
Rancho Cucamonga, CA 91730
Phone
(909) 466-8810
NPI assigned
Apr 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Parvaneh Azmoon
Title
President
Phone
(909) 466-8810

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

10535 Foothill Blvd Ste 365
Rancho Cucamonga, CA 91730

Mailing address

650 S Hill St Ste C7
Los Angeles, CA 90014-1783
Phone (909) 466-8810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180620000831 CA Part B Supplier - Clinic/Group Practice 4284989013 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

650 S Hill St
Ste C7
Los Angeles, CA 90014

10535 Foothill Blvd
Ste 365
Rch Cucamonga, CA 91730
Phone (909) 466-8810

Practitioners & affiliated clinicians

Practitioners 1

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": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1174029631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S HILL ST STE C7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141783",
            "telephone_number": "909-466-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 FOOTHILL BLVD STE 365",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-466-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIO VASCULAR HEALTH AND NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "AZMOON",
        "authorized_official_first_name": "PARVANEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-466-8810"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.