Provider Demographics
NPI:1437793486
Name:HEALTHY HEARTS MEDICAL ASSOCIATION
Entity Type:Organization
Organization Name:HEALTHY HEARTS MEDICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-417-5163
Mailing Address - Street 1:PO BOX 213093
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91921-3093
Mailing Address - Country:US
Mailing Address - Phone:888-417-5163
Mailing Address - Fax:888-316-1604
Practice Address - Street 1:2220 OTAY LAKES RD STE 502121
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1004
Practice Address - Country:US
Practice Address - Phone:888-417-5163
Practice Address - Fax:888-316-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based