Provider Demographics
NPI:1871705897
Name:CARDIAC AND VASCULAR SPECIALISTS OF NORTHERN CALIFORNIA, INC.
Entity type:Organization
Organization Name:CARDIAC AND VASCULAR SPECIALISTS OF NORTHERN CALIFORNIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILIND
Authorized Official - Middle Name:R
Authorized Official - Last Name:DHOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-426-4696
Mailing Address - Street 1:1261 TRAVIS BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4897
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1261 TRAVIS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4897
Practice Address - Country:US
Practice Address - Phone:707-426-4696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05436ZMedicare PIN