Provider Demographics
NPI:1811021470
Name:CALIFORNIA HEART MEDICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:CALIFORNIA HEART MEDICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-438-1111
Mailing Address - Street 1:7215 N FRESNO ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2969
Mailing Address - Country:US
Mailing Address - Phone:559-438-1111
Mailing Address - Fax:559-438-4002
Practice Address - Street 1:7215 N FRESNO ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2969
Practice Address - Country:US
Practice Address - Phone:559-438-1111
Practice Address - Fax:559-438-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44090174400000X
CAA45484174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0071840Medicaid
CAZZZ13475ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CA00A454840Medicare ID - Type UnspecifiedMEDICARE # - DR. SANDHU
CAE34469Medicare UPIN
CA00A440900Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAGR0071840Medicaid