Organization
CALIFORNIA CARDIAC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGHA K KHAN MD (OWNER)
(949) 631-4278
Entity
Organization
Contact information
Practice address
307 PLACENTIA AVE, SUITE 202, NEWPORT BEACH, CA 92663-3310
(949) 631-4278
(949) 548-4278
Mailing address
307 PLACENTIA AVE, SUITE 202, NEWPORT BEACH, CA 92663-3310
(949) 631-4278
(949) 548-4278
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
C53047
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3274073
CA BUSINESS LICENSE
CA
01
—
FNP 40010
FICTITIOUS NAME PERMIT
CA
Enumeration date
05/17/2010
Last updated
09/16/2011
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