The Heart Center of San Diego Medical Group, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G040881 Issued in CA

Legal business name

THE HEART CENTER OF SAN DIEGO MEDICAL GROUP, INC

Practice address

8851 Center Dr Ste 312
La Mesa, CA 91942-3050

Phone

(619) 667-0708

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jack Stuart Madowitz, M.D.

Title

Physician

Phone

(619) 667-0708

Specialties & licenses 1

Addresses

Other names 1

• grossmont heart center medical group, inc Doing business as

Locations

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1477754091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 312",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423050",
            "telephone_number": "619-667-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 312",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423050",
            "telephone_number": "619-667-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEART CENTER OF SAN DIEGO MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "MADOWITZ",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "619-667-0708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G040881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "grossmont heart center medical group, inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phuong T Thai, PHARMD
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• Specialist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.