Organization
LA JOLLA CARDIOVASCULAR MEDICAL ASSOC INC
Active
Organization
LA JOLLA CARDIOVASCULAR MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHIN KERAMATI M.D. (CHIEF EXECUTIVE OFFICER)
(619) 297-0014
Entity
Organization
Contact information
Practice address
501 WASHINGTON ST, SUITE 512, SAN DIEGO, CA 92103-2231
(619) 297-0014
(619) 297-1014
Mailing address
501 WASHINGTON ST, SUITE 512, SAN DIEGO, CA 92103-2231
(619) 297-0014
(619) 297-1014
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G800331
—
CA
01
—
RHC145993
X-RAY/FLUOROSCOPY
CA
Enumeration date
08/02/2006
Last updated
02/14/2011
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