Organization
FONTANA CARDIOVASCULAR GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG P FONTANA MD (PRESIDENT)
(310) 721-2285
Entity
Organization
Contact information
Practice address
8635 WEST THRID STREET, SUITE 750W, LOS ANGELES, CA 90048
(310) 659-2030
Mailing address
9663 SANTA MONICA BLVD, NO 756, BEVERLY HILLS, CA 90210-4303
(310) 721-2285
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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