Active NPI
Southern California Cardiology Medical Group, Inc.
- Non-Pharmacy Dispensing Site
- San Diego, CA
National Provider Identifier
1528405651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-Pharmacy Dispensing Site
- License
- G25708
- Legal business name
- SOUTHERN CALIFORNIA CARDIOLOGY MEDICAL GROUP, INC.
- Doing business as
- Southern California Cardiology Medical Group, Inc.
- Practice address
- 6386 Alvarado CT
Suite 101
San Diego, CA 92120-4905 - Phone
- (619) 265-1237
- NPI assigned
- May 30, 2013
- Organization subpart
- Yes
- Parent organization
- MEDVANTX, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenny Heine
- Title
- VP of Operations
- Phone
- (858) 964-1506
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | G25708 | CA | Primary |
Addresses
Primary practice location
6386 Alvarado CT
Suite 101
San Diego, CA 92120-4905
Mailing address
5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705
Other names 1
- Southern California Cardiology Medical Group, Inc.
National Provider Directory
National Provider Directory- Part of
- Tri - State Medical Group Inc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- San Diego, CA
- NPI 1861544850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370390400000",
"number": "1528405651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5626 OBERLIN DR",
"address_2": "SUITE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6386 ALVARADO CT",
"address_2": "SUITE 101",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921204905",
"telephone_number": "619-265-1237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN CALIFORNIA CARDIOLOGY MEDICAL GROUP, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MEDVANTX, INC.",
"enumeration_date": "2013-05-30",
"last_updated": "2013-06-05",
"status": "A",
"authorized_official_last_name": "HEINE",
"authorized_official_first_name": "KENNY",
"authorized_official_title_or_position": "VP OF OPERATIONS",
"authorized_official_telephone_number": "858-964-1506"
},
"taxonomies": [
{
"code": "332900000X",
"taxonomy_group": "",
"desc": "Non-Pharmacy Dispensing Site",
"state": "CA",
"license": "G25708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southern California Cardiology Medical Group, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Diego, CA
- Aryn South
- Lauren R South, LPCC
- Chris Keith Southard, M.A.
- Southbay Urgent Care Inc
- Southern California Cardiology Medical Group Inc
- Southern California Compounding Pharmacy
- Southern California Gastroenterology Anesthesia Specia (Southern California Gastroenterology Anesthesia Specialists)
- Southern California Interventional Associates, PC
- Southern California Permanente Medical Group (Target Clinic Medical Associates of Southern California)
- Southern California Permanente Medical Group
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.