Organization
NORTHERN CALIFORNIA CARDIOLOGY ASSOCIATES MEDICAL GROUP INC
Active
Organization
NORTHERN CALIFORNIA CARDIOLOGY ASSOCIATES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R. VETTER M.D. (PRESIDENT)
(916) 733-1788
Entity
Organization
Contact information
Practice address
5301 F ST, #117, SACRAMENTO, CA 95819-3226
(916) 733-1788
(916) 733-1787
Mailing address
1330 21ST STREET #201, C/O MIDTOWN FINANCIAL, SACRAMENTO, CA 95811-4231
(916) 561-6848
(916) 447-9210
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RC0000X
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
207RC0001X
CA
207RI0011X
Interventional Cardiology Physician
207R10011X
CA
207UN0901X
Nuclear Cardiology Physician
207UN0901X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA7085
RAILROAD MEDICARE PIN
CA
01
—
DB9095
RAILROAD MEDICARE PIN
CA
05
—
GR0063160
—
CA
05
—
GR0063161
—
CA
05
—
GR0063162
—
CA
05
—
GR0063163
—
CA
05
—
GR0063164
—
CA
01
—
ZZZ07522Z
BLUE SHIELD OF CA
CA
01
—
ZZZ075232
BLUE SHIELD OF CA
CA
01
—
ZZZ07524Z
BLUE SHIELD OF CA
CA
01
—
ZZZ08053Z
BLUE SHIELD OF CA
CA
01
—
ZZZ66346Z
BLUE SHIELD OF CA
CA
Enumeration date
08/22/2005
Last updated
10/20/2009
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