Organization Active NPI

Inland Cardiothoracic Surgical Associates Medical Group

  • Specialist
  • Apple Valley, CA
National Provider Identifier
1346271533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
INLAND CARDIOTHORACIC SURGICAL ASSOCIATES MEDICAL GROUP
Practice address
16051 Kasota Rd
Suite 900
Apple Valley, CA 92307-2215
Phone
(760) 946-8181
Fax
(760) 946-8184
NPI assigned
Jul 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Mrs. Terri L King, CMA
Title
Director of Operations
Phone
(909) 881-1614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

16051 Kasota Rd
Suite 900
Apple Valley, CA 92307-2215

Mailing address

401 E Highland Ave
Suite 251
San Bernardino, CA 92404-3803
Phone (909) 881-1614

Other identifiers 1

IdentifierTypeStateIssuer
GR0049932MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Inland Cardiothoracic Surgical Associates Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346271533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE",
            "address_2": "SUITE 251",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043803",
            "telephone_number": "909-881-1614",
            "fax_number": "909-881-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16051 KASOTA RD",
            "address_2": "SUITE 900",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072215",
            "telephone_number": "760-946-8181",
            "fax_number": "760-946-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND CARDIOTHORACIC SURGICAL ASSOCIATES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "909-881-1614",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0049932",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, 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.