Citrus Valley Cardiology Medical Group Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CITRUS VALLEY CARDIOLOGY MEDICAL GROUP INC

Practice address

353 W Foothill Blvd
Glendora, CA 91741-3359

Phone

(626) 857-7344

Fax

(626) 857-7340

NPI assigned

Jan 10, 2007

Last updated

Sep 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Neil E Doherty III, MD

Title

Ceo

Phone

(626) 857-7344

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1174672794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413359",
            "telephone_number": "626-857-7344",
            "fax_number": "626-857-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413359",
            "telephone_number": "626-857-7344",
            "fax_number": "626-857-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS VALLEY CARDIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-857-7344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084810",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ29233Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chronic Pain Management Clinic a Medical Corporation
• Howard Chudler, MFT
• Joy Jia I Chung, M.S.
• Laura Goss Cina, MFT
• Citrus Community College
• Citrus Valley Gastroenterology a Medical Corporation
• Citrus Valley Physician Partners
• Citrus Valley Urologic Medical Group, Inc.
• Matthew Clayson, DPM
• Coast to Coast Medical Inc

• Cardiovascular Disease Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.