NPIMap

Organization Active NPI

Cardiovascular Consultants Medical Group, Inc.

  • Interventional Cardiology Physician
  • Oakland, CA
National Provider Identifier
1629013842
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC.
Practice address
365 Hawthorne Ave
#201
Oakland, CA 94609-3107
Phone
(510) 452-1345
Fax
(510) 452-1102
NPI assigned
Jun 19, 2006
Last updated
Jun 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Paul L Ludmer, MDNPI 1316976913
Title
President
Phone
(510) 452-1345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU Primary

Addresses

Primary practice location

365 Hawthorne Ave
#201
Oakland, CA 94609-3107

Mailing address

2855 Mitchell Dr
#223
Walnut Creek, CA 94598-1600
Phone (510) 452-1345

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ56221ZOtherCABLUE SHIELD PROVIDER NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1629013842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 MITCHELL DR",
            "address_2": "#223",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981600",
            "telephone_number": "510-452-1345",
            "fax_number": "510-452-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "#201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093107",
            "telephone_number": "510-452-1345",
            "fax_number": "510-452-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "LUDMER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-452-1345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "ZZZ56221Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.