# CALIFORNIA CENTER FOR CARDIOTHORACIC SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316976327
- **Authorized official:** GHOLAM R MOHAMMADZADEH MD (PARTNER PHYSICIAN)
- **Authorized official phone:** (805) 379-9456

## Contact information

- **Practice address:** 2100 LYNN RD, SUITE 100, THOUSAND OAKS, CA 91360
- **Practice address phone:** (805) 379-9456
- **Practice address fax:** (805) 494-4330
- **Mailing address:** 2190 LYNN RD, SUITE 220, THOUSAND OAKS, CA 91360
- **Mailing address phone:** (805) 495-8050
- **Mailing address fax:** (805) 496-2160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CK7028 | RAILROAD MEDICARE | — |
| 05 | — | GR0083753 | — | CA |
| 01 | — | ZZZ23109Z | BLUE SHIELD | — |