Organization
CARDIAC INSTITUTE OF CENTRAL CALIFORNIA A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM A BORNO MD (OWNER/PRESIDENT)
(559) 256-5500
Entity
Organization
Contact information
Practice address
30 RIVER PARK PLACE W, 440, FRESNO, CA 93720
(559) 256-5500
(559) 256-5505
Mailing address
30 RIVER PARK PLACE W, 440, FRESNO, CA 93720
(559) 256-5500
(559) 256-5505
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098720
—
CA
01
—
ZZZ29724Z
MEDICARE PTAN
—
Enumeration date
08/08/2006
Last updated
03/14/2013
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