Provider Demographics
NPI:1235165911
Name:CARDIOLOGY CONSULTANTS OF SANTA MONICA INC
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF SANTA MONICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOHLGELERNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-315-0101
Mailing Address - Street 1:1301 20TH ST
Mailing Address - Street 2:STE 590
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-836-2794
Mailing Address - Fax:
Practice Address - Street 1:1301 20TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2054
Practice Address - Country:US
Practice Address - Phone:310-315-0101
Practice Address - Fax:310-453-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHW1249Medicare PIN
CAW1249Medicare PIN
CAHW1249AMedicare PIN