Organization
WEST COAST CARDIOLOGY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNA BALL (ADMINISTRATOR)
(310) 671-9802
Entity
Organization
Contact information
Practice address
575 E HARDY ST, SUITE 104, INGLEWOOD, CA 90301-4036
(310) 671-9802
(310) 671-5011
Mailing address
575 E HARDY ST, SUITE 104, INGLEWOOD, CA 90301-4036
(310) 671-9802
(310) 671-5011
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A33600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060020745
RAILROAD MEDICARE
CA
05
—
GR0066190
—
CA
Enumeration date
07/08/2006
Last updated
12/17/2007
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