Provider Demographics
NPI:1790766038
Name:SAN DIEGO CARDIOVASCULAR AND THORACIC SURGEONS, INC.
Entity Type:Organization
Organization Name:SAN DIEGO CARDIOVASCULAR AND THORACIC SURGEONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-939-7471
Mailing Address - Street 1:8010 FROST ST.
Mailing Address - Street 2:STE. 408
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-939-7471
Mailing Address - Fax:
Practice Address - Street 1:8010 FROST ST.
Practice Address - Street 2:STE. 408
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-939-7471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB2003016851208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16526Medicare PIN