Provider Demographics
NPI:1922140854
Name:CARDIOLOGY CARE OF THE HEART PATIENT INC.
Entity Type:Organization
Organization Name:CARDIOLOGY CARE OF THE HEART PATIENT INC.
Other - Org Name:CARDIOLOGY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:626-340-4888
Mailing Address - Street 1:630 SOUTH RAYMOND AVE.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3283
Mailing Address - Country:US
Mailing Address - Phone:626-340-4888
Mailing Address - Fax:626-389-0217
Practice Address - Street 1:630 SOUTH RAYMOND AVE.
Practice Address - Street 2:SUITE 204
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3283
Practice Address - Country:US
Practice Address - Phone:626-340-4888
Practice Address - Fax:626-389-0217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28352174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43700Medicare UPIN