Provider Demographics
NPI:1265481824
Name:ADVANCED CARDIAC MONITORING, INC.
Entity Type:Organization
Organization Name:ADVANCED CARDIAC MONITORING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:KIANPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:818-692-4354
Mailing Address - Street 1:2331 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 321
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2109
Mailing Address - Country:US
Mailing Address - Phone:818-692-4354
Mailing Address - Fax:310-470-9779
Practice Address - Street 1:10757 CLARKSON RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4251
Practice Address - Country:US
Practice Address - Phone:818-692-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG016Medicare ID - Type UnspecifiedIDTF