Organization
CARDIO VASCULAR PLUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN LOUIS DAGOSTINO (PRESIDENT)
(951) 789-4356
Entity
Organization
Contact information
Practice address
7893 MISSION GROVE PKWY S, SUITE B, RIVERSIDE, CA 92508-5087
(951) 789-4356
(951) 789-4294
Mailing address
18700 NEWMAN AVE, RIVERSIDE, CA 92508-9446
(951) 789-4356
(951) 789-4294
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D1030088
CA
291U00000X
Clinical Medical Laboratory
CLR332061
CA
331L00000X
Blood Bank
SR EH 52034861
CA
332BC3200X
Customized Equipment (DME)
SR EH 52-034861
CA
Other
Enumeration date
05/03/2006
Last updated
02/05/2014
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