Provider Demographics
NPI:1669530176
Name:CARDIO-PULMONARY ASSOCIATES MEDICAL GROUP INC A PROFESSIONAL CORP
Entity type:Organization
Organization Name:CARDIO-PULMONARY ASSOCIATES MEDICAL GROUP INC A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:HANS
Authorized Official - Middle Name:
Authorized Official - Last Name:POGGEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-646-8570
Mailing Address - Street 1:PO BOX 3888
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-8888
Mailing Address - Country:US
Mailing Address - Phone:925-718-6622
Mailing Address - Fax:925-626-4666
Practice Address - Street 1:1010 CASS ST STE B1
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4515
Practice Address - Country:US
Practice Address - Phone:831-646-8570
Practice Address - Fax:831-646-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01815ZOtherBS GROUP ID #
CAGR0085950Medicaid
CAZZZ01815ZOtherBS GROUP ID #