Provider Demographics
NPI:1396924205
Name:CARDINAL MEDICAL CENTER, INC
Entity type:Organization
Organization Name:CARDINAL MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINHIERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-403-0199
Mailing Address - Street 1:31457 LAKE VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-5308
Mailing Address - Country:US
Mailing Address - Phone:760-941-8888
Mailing Address - Fax:760-650-3135
Practice Address - Street 1:31457 LAKE VISTA CIR
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-5308
Practice Address - Country:US
Practice Address - Phone:760-717-3450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43808207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW21766OtherMEDICARE PTAN
CA00A438080Medicaid