Provider Demographics
NPI:1164471868
Name:LOS ANGELES CARDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:LOS ANGELES CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-977-7422
Mailing Address - Street 1:1245 WILSHIRE BLVD
Mailing Address - Street 2:STE 703
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4807
Mailing Address - Country:US
Mailing Address - Phone:213-977-7422
Mailing Address - Fax:213-250-9416
Practice Address - Street 1:43723 20TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4784
Practice Address - Country:US
Practice Address - Phone:661-674-4222
Practice Address - Fax:661-674-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0067040Medicaid
CACF9857OtherMEDICARE RAILROAD
CAEG783AMedicare PIN