Provider Demographics
NPI:1518089952
Name:CHULA VISTA HEART CLINIC, INC.
Entity Type:Organization
Organization Name:CHULA VISTA HEART CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZKOPIEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-427-8646
Mailing Address - Street 1:480 4TH AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4410
Mailing Address - Country:US
Mailing Address - Phone:619-427-8646
Mailing Address - Fax:619-425-7128
Practice Address - Street 1:480 4TH AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4410
Practice Address - Country:US
Practice Address - Phone:619-427-8646
Practice Address - Fax:619-425-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty