Provider Demographics
NPI:1164627295
Name:CARDIOLOGY OF SOUTHERN CALIFORNIA
Entity Type:Organization
Organization Name:CARDIOLOGY OF SOUTHERN CALIFORNIA
Other - Org Name:ALBERT J. SHARF MD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-470-7700
Mailing Address - Street 1:P. O. BOX 12607
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92039
Mailing Address - Country:US
Mailing Address - Phone:619-470-7700
Mailing Address - Fax:619-470-0996
Practice Address - Street 1:655 EUCLID AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-470-7700
Practice Address - Fax:619-470-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72122207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G721220Medicaid
CA1649349820OtherINDIVIDUAL NPI#
CAW21020Medicare PIN
CA00G721220Medicaid