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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