Provider Demographics
NPI:1841598323
Name:CARDIOLOGY CLINIC OF NORTHERN CALIFORNIA
Entity Type:Organization
Organization Name:CARDIOLOGY CLINIC OF NORTHERN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-293-5900
Mailing Address - Street 1:969 STORY RD
Mailing Address - Street 2:SUITE 6066
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2690
Mailing Address - Country:US
Mailing Address - Phone:408-293-5900
Mailing Address - Fax:408-293-5901
Practice Address - Street 1:969 STORY RD
Practice Address - Street 2:SUITE 6066
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2690
Practice Address - Country:US
Practice Address - Phone:408-293-5900
Practice Address - Fax:408-293-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90388261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty