Provider Demographics
NPI:1225386642
Name:CALIFORNIA CARDIOVASCULAR
Entity Type:Organization
Organization Name:CALIFORNIA CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-796-0222
Mailing Address - Street 1:2333 MOWRY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1625
Mailing Address - Country:US
Mailing Address - Phone:510-796-0222
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:2333 MOWRY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1625
Practice Address - Country:US
Practice Address - Phone:510-796-0222
Practice Address - Fax:510-796-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50605207R00000X
CAG59337207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty