Organization
CISCO MEDICAL GROUP, INC
Active
Other names
Cisco Medical Group - Reseda
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE FRANCISCO MARTINEZ CARDENAS MD (PRESIDENT/MEDICAL DIRECTOR)
(818) 757-0954
Entity
Organization
Contact information
Practice address
18518 SHERMAN WAY, RESEDA, CA 91335-4212
(818) 757-0954
(818) 757-0963
Mailing address
18518 SHERMAN WAY, RESEDA, CA 91335-4212
(818) 757-0954
(818) 757-0963
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1055441
CLIA
CA
05
—
GR0103250
—
CA
Enumeration date
10/10/2006
Last updated
06/11/2024
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