Provider Demographics
NPI:1891860375
Name:CARDIOLOGY ASSOCIATES OF NORTH CTY INC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NORTH CTY INC
Other - Org Name:EDWARD B EVANS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-941-6664
Mailing Address - Street 1:161 THUNDER DRIVE
Mailing Address - Street 2:#104
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6051
Mailing Address - Country:US
Mailing Address - Phone:760-941-6664
Mailing Address - Fax:760-941-3257
Practice Address - Street 1:161 THUNDER DRIVE
Practice Address - Street 2:#104
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6051
Practice Address - Country:US
Practice Address - Phone:760-941-6664
Practice Address - Fax:760-941-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43785207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G437850Medicaid
CAWG43785COtherMEDICAL
CAWG43785COtherMEDICAL
A92441Medicare UPIN