PACIFIC HEART AND VASCULAR MEDICAL GROUP
Organization (NPI-2)
Active
Internal Medicine, Cardiovascular Disease
Provider Information
- NPI Number
1790712990- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 845 S FAIRMONT AVE SUITE 11, LODI, CA, 952405113
- Phone
- (209) 334-0651
- Fax
- (209) 334-5013
Specialties & Taxonomies
Internal Medicine, Cardiovascular Disease
Primary License: CA #FNP33233