NPIMap

Organization Active NPI

Sun City Cardiology Medical Center, Inc.

  • Cardiovascular Disease Physician
  • Sun City, CA
National Provider Identifier
1982603908
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A49209 Issued in CA
Legal business name
SUN CITY CARDIOLOGY MEDICAL CENTER, INC.
Practice address
27830 Bradley Rd
Sun City, CA 92586-2201
Phone
(951) 672-3888
Fax
(951) 672-3758
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Authorized official

Name
Bhoodev Tiwari, MDNPI 1326047309
Title
Ceo
Phone
(951) 672-3888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A49209 CA Primary

Addresses

Primary practice location

27830 Bradley Rd
Sun City, CA 92586-2201

Mailing address

27830 Bradley Rd
Sun City, CA 92586-2201
Phone (951) 672-3888

Other identifiers 1

IdentifierTypeStateIssuer
A49209OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211001181 CA Part B Supplier - Clinic/Group Practice 9133025836 Receives reassigned benefits from 6 practitioners
Practice locations: Murrieta, CA; Sun City, CA; Temecula, CA

National Provider Directory

National Provider Directory
Tax ID family
Stephanus Ong MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

28078 Baxter Rd
Ste 428
Murrieta, CA 92563
Phone (951) 246-8881

36320 Inland Valley Dr
Ste 301
Wildomar, CA 92595
Phone (951) 447-8826

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1982603908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862201",
            "telephone_number": "951-672-3888",
            "fax_number": "951-672-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862201",
            "telephone_number": "951-672-3888",
            "fax_number": "951-672-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN CITY CARDIOLOGY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "TIWARI",
        "authorized_official_first_name": "BHOODEV",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-672-3888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A49209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A49209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.