CARDIOLOGY PRACTICE MEDICAL GROUP (NPI# 1629132535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629132535 |
| Entity Type | Organization |
| Organization Name | CARDIOLOGY PRACTICE MEDICAL GROUP |
| Practice Address |
17075 Devonshire St Ste 201 Northridge CA 91325-5407 |
| Practice Telephone | 8183659595 |
| Practice Fax Number | 8183658955 |
| Mailing Telephone | 8183659595 |
| Mailing Fax Number | 8183658955 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2010-06-15 |
| Authorized Official Name | DR. RICHARD FERNANDO PEGO (PRESIDENT) |
| Authorized Official Telephone | 8183659595 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A33230 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD | 060067979 | 01 |
| CA | GR0091580 | 05 | |
| CA | BLUE SHIELD | 222031992 | 01 |
| Street Address |
17075 DEVONSHIRE ST STE 201 |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91325-5407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790017218 | Saman Fakheri | Internal Medicine | 17075 Devonshire St Ste 201, Northridge, CA 91325-5405 | 2010-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346961 | Patricia Yamilet Morales | Registered Nurse | 18300 Roscoe Blvd Dignity Health- Northridge Hospital M, Northridge, CA 91325 | 2020-11-02 |
| 1790342897 | Northridge Kidney Center, LLC | Clinic/Center | 17710 Roscoe Blvd, Northridge, CA 91325 | 2019-05-23 |
| 1063078376 | Ozlem Alper | Student in an Organized Health Care Education/Training Program | 18497 Dearborn St, Unit 112, Northridge, CA 91325 | 2019-05-13 |
| 1144883489 | Better Sober | Clinic/Center | 9339 Louse Ave, Northridge, CA 91325 | 2019-04-22 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
| 1043713969 | Poly-med Pharmacy Inc | Pharmacy | 17313 Roscoe Blvd, Northridge, CA 91325 | 2018-03-16 |
| 1982151940 | Maria Dakessian | Dentist | 18250 Roscoe Blvd Ste 345, Northridge, CA 91325 | 2016-09-07 |
| 1487019469 | Beshoy Gerges | Pharmacist | 8254 White Oak Ave Unit 4, Northridge, CA 91325 | 2015-12-17 |
| 1235520305 | Gema Bautista | Social Worker | 8550 Balboa Blvd Ste 216, Northridge, CA 91325 | 2015-02-11 |
| 1083018873 | Sosann Haider | Pharmacist | 18444 Plummer St., Northridge, CA 91325 | 2014-10-22 |
| Find all providers in zip 91325 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720426489 | Melinda Rachel Wilson | Specialist | 18618 Rayen St, Northridge, CA 91324-4030 | 2013-06-04 |
| 1699053397 | Donald Rex Simpson | Specialist | 17425 Parthenia St, Northridge, CA 91325-3240 | 2011-07-28 |
| 1568689966 | Valley Pulmonary Medical Group | Specialist | 18546 Roscoe Blvd Ste 308, Northridge, CA 91324-4669 | 2007-04-19 |
| 1720123458 | Alan Cohler | Specialist | 9731 Bothwell Rd, Northridge, CA 91311 | 2007-02-20 |
| 1811032923 | Adel F. Jabour, M.d Inc | Specialist | 18350 Roscoe Blvd Ste 200, Northridge, CA 91325-4147 | 2007-02-20 |
| 1528123346 | Gps Medical, Inc | Specialist | 17075 Devonshire St #201, Northridge, CA 91325-5407 | 2006-12-22 |
| 1063585164 | Samuel Leibovici | Specialist | 18250 Roscoe Blvd Ste 200, Northridge, CA 91325-4226 | 2006-11-16 |
| 1730251414 | David H Zimmer | Specialist | 18810 Kirkcolm Ln, Northridge, CA 91326-1142 | 2006-11-15 |
| 1144242645 | Richard Kenneth Gordon | Specialist | 8700 Reseda Blvd, Suite 204, Northridge, CA 91324-4041 | 2006-07-24 |
| 1275565608 | Marc M Kerner | Specialist | 18350 Roscoe Blvd Ste 318, Northridge, CA 91325-4164 | 2006-07-07 |
| Find all providers in NORTHRIDGE | ||||
| City | NORTHRIDGE |
| Zip Code | 91325 |
Please comment or provide details below to improve the information on CARDIOLOGY PRACTICE MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.