Provider Demographics
NPI:1437206075
Name:CARDIOPULMONARY SERVICES SOUTHERN CALIFORNIA
Entity Type:Organization
Organization Name:CARDIOPULMONARY SERVICES SOUTHERN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:CASS
Authorized Official - Suffix:
Authorized Official - Credentials:RESPIRATORY PRACTITI
Authorized Official - Phone:562-208-1766
Mailing Address - Street 1:3440 SNOWDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2940
Mailing Address - Country:US
Mailing Address - Phone:562-208-1766
Mailing Address - Fax:562-420-1106
Practice Address - Street 1:3440 SNOWDEN AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2940
Practice Address - Country:US
Practice Address - Phone:562-208-1766
Practice Address - Fax:562-420-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101316332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1010370001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER