Organization
CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL L LUDMER MD (PRESIDENT)
(510) 452-1345
Entity
Organization
Contact information
Practice address
106 LA CASA VIA, #140, WALNUT CREEK, CA 94598-3086
(925) 274-2860
(925) 932-4527
Mailing address
2855 MITCHELL DR, #223, WALNUT CREEK, CA 94598-1600
(925) 274-2860
(925) 932-4527
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ56224Z
BLUE SHIELD PROVIDER NUMBER
CA
Enumeration date
06/29/2006
Last updated
06/25/2010
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