California Cardiac Center, Inc.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

C53047 Issued in CA

Legal business name

CALIFORNIA CARDIAC CENTER, INC.

Practice address

307 Placentia Ave
Suite 202
Newport Beach, CA 92663-3310

Phone

(949) 631-4278

Fax

(949) 548-4278

NPI assigned

May 17, 2010

Organization subpart

No

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

Authorized official

Name

Agha K Khan, MD

Title

Owner

Phone

(949) 631-4278

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1720307655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 PLACENTIA AVE",
            "address_2": "SUITE 202",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633310",
            "telephone_number": "949-631-4278",
            "fax_number": "949-548-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 PLACENTIA AVE",
            "address_2": "SUITE 202",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633310",
            "telephone_number": "949-631-4278",
            "fax_number": "949-548-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CARDIAC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-17",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AGHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-631-4278",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "C53047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FICTITIOUS NAME PERMIT",
            "identifier": "FNP 40010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BUSINESS LICENSE",
            "identifier": "C3274073",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.