Organization Active NPI

Cardiac Surgery West Medical Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Sacramento, CA
National Provider Identifier
1174565584
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
97989 Issued in CA
Legal business name
CARDIAC SURGERY WEST MEDICAL CORPORATION
Practice address
3941 J St
Suite 270
Sacramento, CA 95819-3628
Phone
(916) 733-6850
Fax
(916) 733-6824
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Allen S Morris, M.D.
Title
Secretary/Treasurer
Phone
(916) 733-6850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X 97989 CA Primary

Addresses

Primary practice location

3941 J St
Suite 270
Sacramento, CA 95819-3628

Mailing address

3941 J St
Suite 270
Sacramento, CA 95819-3628
Phone (916) 733-6850

Other identifiers 1

IdentifierTypeStateIssuer
GR0098280MedicaidCA

Other names 1

  • Cardiac & Thoracic Surgery Medical Group Former legal business name

National Provider Directory

National Provider Directory

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174565584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 J ST",
            "address_2": "SUITE 270",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193628",
            "telephone_number": "916-733-6850",
            "fax_number": "916-733-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 J ST",
            "address_2": "SUITE 270",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193628",
            "telephone_number": "916-733-6850",
            "fax_number": "916-733-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC SURGERY WEST MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "916-733-6850",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "97989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiac & Thoracic Surgery Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.