Organization
CARDIOVASCULAR IMAGING MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S TSAKONAS MD (PRESIDENT)
(818) 782-5041
Entity
Organization
Contact information
Practice address
15031 RINALDI ST, MISSION HILLS, CA 91345-1207
(818) 782-5041
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085471
—
CA
Enumeration date
04/18/2006
Last updated
04/21/2008
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