Organization
CARDIOVASCULAR PERFUSION SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE ARTHUR RANDOLPH CCP (PRESIDENT)
(805) 428-1275
Entity
Organization
Contact information
Practice address
1330 CORTE DE PRIMAVERA, THOUSAND OAKS, CA 91360-7026
(805) 428-1275
(805) 523-2845
Mailing address
1330 CORTE DE PRIMAVERA, THOUSAND OAKS, CA 91360-7026
(805) 428-1275
(805) 523-2845
Taxonomy
Speciality
Code
Description
License number
State
246XC2903X
Vascular Specialist/Technologist Cardiovascular
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246XC2903X
TECNOLGISTS, TECHNICIANS
CA
Enumeration date
09/20/2006
Last updated
07/21/2022
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