Organization
PACIFIC HEART INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORALEE HAYCOCK (BUSINESS OFFICE MANAGER)
(424) 238-1792
Entity
Organization
Contact information
Practice address
2001 SANTA MONICA BLVD, 280W, SANTA MONICA, CA 90404-2102
(310) 829-7678
(310) 449-6958
Mailing address
2001 SANTA MONICA BLVD, 280W, SANTA MONICA, CA 90404-2102
(310) 829-7678
(310) 449-6958
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10022550
LABORATORY ECHOCARDIOGRAPHY
CA
01
—
B1393570420
LABORATORY NUCLEAR
CA
05
—
GR0050330
—
CA
Enumeration date
03/23/2006
Last updated
02/04/2014
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