# CALIFORNIA CENTER FOR CARDIOTHORACIC SURGERY, A MEDICAL GROUP

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

## Provider details

- **NPI number:** 1588872907
- **Authorized official:** DR. GHOLAM R MOHAMMADZADEH MD (PARTNER PHYSICIAN)
- **Authorized official phone:** (805) 379-9456

## Contact information

- **Practice address:** 16255 VENTURA BLVD, SUITE 910, ENCINO, CA 91436-2302
- **Practice address phone:** (818) 990-4600
- **Practice address fax:** (818) 990-7841
- **Mailing address:** 2190 LYNN RD, SUITE 220, THOUSAND OAKS, CA 91360-1980
- **Mailing address phone:** (805) 495-8050
- **Mailing address fax:** (805) 496-2160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 06/30/2008