San Joaquin Cardiology Medical Group Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

SAN JOAQUIN CARDIOLOGY MEDICAL GROUP INC

Practice address

2800 N California St Ste 14
Stockton, CA 95204-3759

Phone

(209) 942-1005

Fax

(209) 942-0455

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Patty S Balderston

Title

Administrator

Phone

(209) 942-1005

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syed Umer Ali, MD

  • Interventional Cardiology Physician
  • Stockton, CA
  • NPI 1982997342
  Medicare reassignment Care Compare group NPD
• Cyrus Buhari, DO

  • Interventional Cardiology Physician
  • Stockton, CA
  • NPI 1679581268

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Fram Buhari, MD

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1811906894
  Medicare reassignment Care Compare group NPD
• Alvin Cacho, M.D.

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1205918497
  Medicare reassignment Care Compare group NPD
• Muhammad W Choudhry, MD

  • Interventional Cardiology Physician
  • Stockton, CA
  • NPI 1962715987

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Adnan Khan, M.D.

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1285928705
  Medicare reassignment Care Compare group NPD
• Elizabeth Phung-Hart, D.O.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1649681636

  CA

  Medicare reassignment Care Compare group NPD
• Gurinder Grewal, M.D.

  • Cardiovascular Disease Physician
  • Tracy, CA
  • NPI 1942389580
  Medicare reassignment NPD
• Noel Lena Moreno, PA-C

  • Medical Physician Assistant
  • Stockton, CA
  • NPI 1932434404
  Medicare reassignment
• Ramin Manshadi, MD

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1629171202
  NPD
• Hooman Madyoon, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1285696476

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1497785455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST",
            "address_2": "SUITE 14",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95204",
            "telephone_number": "209-942-1005",
            "fax_number": "209-942-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST STE 14",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043759",
            "telephone_number": "209-942-1005",
            "fax_number": "209-942-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN CARDIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "BALDERSTON",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-942-1005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062380",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC6353",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harsimran Kaur Samrao
• Samuel B Bockari
• San Joaquin AIDS Foundation
• San Joaquin Behavioral Health Services
• San Joaquin Behavioral Health Services
• San Joaquin Community Foundation
• San Joaquin County
• San Joaquin County - Hsa - Acs
• San Joaquin County Behavioral Health
• San Joaquin County Behavioral Health

• Cardiovascular Disease Physician in Stockton, CA
• Providers in Stockton, 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 Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.