Organization
CARDIOVASCULAR CONSULTANTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLEY A LITKE (ASST ADMINISTRATOR)
(818) 782-5041
Entity
Organization
Contact information
Practice address
16542 VENTURA BLVD STE 402, ENCINO, CA 91436-4562
(818) 782-5041
(818) 205-9091
Mailing address
16542 VENTURA BLVD STE 402, ENCINO, CA 91436-4562
(818) 782-5041
(818) 205-9091
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
FNP7299
CA
207RC0000X
Cardiovascular Disease Physician
—
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
CA
207RI0011X
Interventional Cardiology Physician
—
CA
207UN0901X
Nuclear Cardiology Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0026710
—
CA
05
—
GR0026711
—
CA
05
—
GR0026712
—
CA
Enumeration date
12/28/2005
Last updated
08/23/2022
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