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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