Provider Demographics
NPI:1881740827
Name:ASSOCIATES IN CARDIO-THORACIC SURGERY,A MEDICAL GROUP INC.
Entity type:Organization
Organization Name:ASSOCIATES IN CARDIO-THORACIC SURGERY,A MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-831-8800
Mailing Address - Street 1:1 SHRADER ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1016
Mailing Address - Country:US
Mailing Address - Phone:415-831-8800
Mailing Address - Fax:415-884-4468
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-831-8800
Practice Address - Fax:415-884-4468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22244208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G222440Medicaid
CAF70758Medicare UPIN
CA00G222440Medicare ID - Type Unspecified