Provider Demographics
NPI:1518985431
Name:CARDIAC ULTRASOUND INC
Entity Type:Organization
Organization Name:CARDIAC ULTRASOUND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:P
Authorized Official - Last Name:KLIMO
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RDCS, RVT
Authorized Official - Phone:818-203-1013
Mailing Address - Street 1:6145 SHOUP AVE UNIT 45
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3333
Mailing Address - Country:US
Mailing Address - Phone:818-203-1013
Mailing Address - Fax:818-594-0878
Practice Address - Street 1:6145 SHOUP AVE UNIT 45
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3333
Practice Address - Country:US
Practice Address - Phone:818-203-1013
Practice Address - Fax:818-594-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG258Medicare PIN