Provider Demographics
NPI:1750670295
Name:HEART INSTITUTE OF SOUTHERN CALIFORNIA, APMC
Entity Type:Organization
Organization Name:HEART INSTITUTE OF SOUTHERN CALIFORNIA, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KATSIYIANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-302-0606
Mailing Address - Street 1:PO BOX 1284
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92593-1284
Mailing Address - Country:US
Mailing Address - Phone:951-302-0606
Mailing Address - Fax:
Practice Address - Street 1:31720 TEMECULA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5895
Practice Address - Country:US
Practice Address - Phone:951-302-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty