Mirko a Giaconi MD Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A25678 Issued in CA

Legal business name

MIRKO A GIACONI MD INC

Practice address

1360 West 6TH St
Ste 205
San Pedro, CA 90732

Phone

(310) 832-7541

Fax

(310) 832-3585

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Mirko Andrew Giaconi, MD

Title

President

Phone

(310) 832-7541

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1750398491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 WEST 6TH ST",
            "address_2": "STE 205",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-832-7541",
            "fax_number": "310-832-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 WEST 6TH ST",
            "address_2": "STE 205",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-832-7541",
            "fax_number": "310-832-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRKO A GIACONI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "GIACONI",
        "authorized_official_first_name": "MIRKO",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-832-7541",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A25678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A25678",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Joel Miller, MD
• Nancy Miller, PHD
• Paul Miller
• Mindbender LLC
• Sara Marie Mindell, RN
• Sameer Dhiru Mistry, M.D.
• Mallory Lorraine Molle, M.S.
• Phyllis R. Monroe, M.D.
• Kayla Monroy, ATC
• Bryant Montoya

• Cardiovascular Disease Physician in San Pedro, CA
• Providers in San Pedro, 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 Feb 28, 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.

Verify at the official NPI Registry.