Provider Demographics
NPI:1659420495
Name:CALIFORNIA HEART ASSOCIATES
Entity Type:Organization
Organization Name:CALIFORNIA HEART ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-546-2238
Mailing Address - Street 1:18111 BROOKHURST ST
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6728
Mailing Address - Country:US
Mailing Address - Phone:714-546-2238
Mailing Address - Fax:714-434-8145
Practice Address - Street 1:18111 BROOKHURST ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-546-2238
Practice Address - Fax:714-434-8145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY49298YMedicaid
CA=========OtherTAX ID
CA=========OtherTAX ID