Provider Demographics
NPI:1114081163
Name:CARDIO DATA
Entity Type:Organization
Organization Name:CARDIO DATA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GURINDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-435-7956
Mailing Address - Street 1:PO BOX 18583
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-8583
Mailing Address - Country:US
Mailing Address - Phone:714-435-7956
Mailing Address - Fax:714-966-2966
Practice Address - Street 1:17150 EUCLID ST STE 306
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4092
Practice Address - Country:US
Practice Address - Phone:714-435-7956
Practice Address - Fax:714-966-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG096Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER