Organization
SOUTHERN CALIFORNIA CARDIOLOGY MEDICAL GROUP, INC.
Active
Parent organization
MEDVANTX, INC.
Other names
Southern California Cardiology Medical Group, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
6386 ALVARADO CT, SUITE 101, SAN DIEGO, CA 92120-4905
(619) 265-1237
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G25708
CA
Other
Enumeration date
05/30/2013
Last updated
06/05/2013
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