Organization
CARDIOLOGY CONSULTANTS MEDICAL GROUP OF THE VALLEY INC.
Active
Organization
CARDIOLOGY CONSULTANTS MEDICAL GROUP OF THE VALLEY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNETTE DES BAILLETS (CHIEF OPERATING OFFICER)
(818) 345-5580
Entity
Organization
Contact information
Practice address
18370 BURBANK BLVD, SUITE 707, TARZANA, CA 91356-2804
(818) 345-5580
(818) 345-5876
Mailing address
18370 BURBANK BLVD, SUITE 707, TARZANA, CA 91356-2804
(818) 345-5580
(818) 345-5876
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376582759
ANTHEM BLUE CROSS
CA
Enumeration date
06/04/2006
Last updated
01/14/2010
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