Provider Demographics
NPI:1295881860
Name:PACIFIC CARDIOVASCULAR SURGEONS A MEDICAL CORPORATION
Entity type:Organization
Organization Name:PACIFIC CARDIOVASCULAR SURGEONS A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMINA
Authorized Official - Middle Name:SILVE
Authorized Official - Last Name:PAES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-991-2662
Mailing Address - Street 1:1800 SULLIVAN AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2259
Mailing Address - Country:US
Mailing Address - Phone:650-636-4462
Mailing Address - Fax:650-636-4463
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2259
Practice Address - Country:US
Practice Address - Phone:650-636-4462
Practice Address - Fax:650-636-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty