Provider Demographics
NPI:1689786436
Name:CARDIAC MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:CARDIAC MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ROJO
Authorized Official - Last Name:TREIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-260-0750
Mailing Address - Street 1:220 NORTH GLENOAKS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502
Mailing Address - Country:US
Mailing Address - Phone:818-260-0750
Mailing Address - Fax:818-260-0257
Practice Address - Street 1:220 NORTH GLENOAKS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502
Practice Address - Country:US
Practice Address - Phone:818-260-0750
Practice Address - Fax:818-260-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG027Medicare ID - Type Unspecified