Provider Demographics
NPI:1396980157
Name:WEST COAST CARDIOLOGY
Entity type:Organization
Organization Name:WEST COAST CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GABOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:JILLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-740-4812
Mailing Address - Street 1:7560 N 71ST ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4801
Mailing Address - Country:US
Mailing Address - Phone:623-583-2073
Mailing Address - Fax:
Practice Address - Street 1:7560 N 71ST ST
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-4801
Practice Address - Country:US
Practice Address - Phone:623-583-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14750207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty