Advanced Cardiothoracic Surgery Medical Group, INC.
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Los Angeles, CA. Organization (NPI-2).
NPI number1104818715
StatusActive
Last updated in NPPESSep 29, 2011
Details
- NPI
- 1104818715
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Cardiothoracic Surgery Medical Group, INC.
- Organization subpart
- No
- Enumeration date
- Aug 19, 2005
- Last updated
- Sep 29, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | G72926 | CA | Yes |
Practice location
1245 Wilshire BlvdSuite 606
Los Angeles, CA 90017-4810
Phone 213-483-1055 · Fax 213-483-1418
Mailing address
1245 Wilshire BlvdSuite 606
Los Angeles, CA 90017-4810
Phone 213-483-1055 · Fax 213-483-1418
Authorized official
Ali Gheissari
President
2134831055
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