Organization
INTERVENTIONAL CARDIOLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACIE CONNOLLY (DIRECTOR OF OPERATIONS & DEVLOPMENT)
(818) 702-8800
Entity
Organization
Contact information
Practice address
7301 MEDICAL CENTER DR STE 201, WEST HILLS, CA 91307-1935
(818) 702-8800
(818) 702-0080
Mailing address
7301 MEDICAL CENTER DR STE 201, WEST HILLS, CA 91307-1935
(818) 702-8800
(818) 702-0080
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
CA
207RI0011X
Interventional Cardiology Physician
—
CA
207UN0902X
Nuclear Imaging & Therapy Physician
—
CA
Other
Enumeration date
02/15/2006
Last updated
07/07/2025
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