Provider Demographics
NPI:1669850236
Name:CARDIAC CENTER OF AMERICA INC
Entity Type:Organization
Organization Name:CARDIAC CENTER OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUNASALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-241-2270
Mailing Address - Street 1:10722 ARROW RTE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4808
Mailing Address - Country:US
Mailing Address - Phone:909-484-2865
Mailing Address - Fax:909-941-6974
Practice Address - Street 1:10722 ARROW RTE
Practice Address - Street 2:SUITE 304
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4808
Practice Address - Country:US
Practice Address - Phone:909-484-2865
Practice Address - Fax:909-941-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty