CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC. (NPI# 1538197413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538197413 |
| Entity Type | Organization |
| Organization Name | CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC. |
| Practice Address |
106 La Casa Via #140 Walnut Creek CA 94598-3086 |
| Mailing Address |
2855 Mitchell Dr #223 Walnut Creek CA 94598-1600 |
| Practice Telephone | 9252742860 |
| Practice Fax Number | 9259324527 |
| Mailing Telephone | 9252742860 |
| Mailing Fax Number | 9259324527 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | PAUL L LUDMER (PRESIDENT) |
| Authorized Official Telephone | 5104521345 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD PROVIDER NUMBER | ZZZ56224Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770780355 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 2855 Mitchell Dr Ste 223, Walnut Creek, CA 94598-1609 | 2007-06-28 |
| 1720225808 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 6380 Clark Ave, Dublin, CA 94568-3036 | 2009-01-12 |
| 1629013842 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 365 Hawthorne Ave, #201, Oakland, CA 94609-3107 | 2006-06-19 |
| 1710922034 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 5201 Norris Canyon Rd, #220, San Ramon, CA 94583-5411 | 2006-06-19 |
| 1437194750 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 2400 Balfour Rd, #215, Brentwood, CA 94513-4945 | 2006-06-19 |
| 1275578478 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 400 Taylor Blvd, #101, Pleasant Hill, CA 94523-2147 | 2006-06-19 |
| 1437194677 | Cardiovascular Consultants Medical Group, Inc. | Internal Medicine | 20126 Stanton Ave, #100, Castro Valley, CA 94546-5271 | 2006-06-19 |
| Street Address |
106 LA CASA VIA #140 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-3086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578599163 | Kristine W Batten | Internal Medicine | 106 La Casa Via, #140, Walnut Creek, CA 94598-3086 | 2006-06-24 |
| 1619425584 | Kelli Patin | Dietitian, Registered | 106 La Casa Via, Suite 100, Walnut Creek, CA 94598-3086 | 2016-09-20 |
| 1922470863 | University Healthcare Alliance | Internal Medicine | 106 La Casa Via, Suite 260, Walnut Creek, CA 94598-3086 | 2015-10-29 |
| 1780073759 | Hk Facial Plastic Surgery, Inc | Otolaryngology | 106 La Casa Via, #200, Walnut Creek, CA 94598-3086 | 2015-01-14 |
| 1447677141 | Erin Walker | Physician Assistant | 106 La Casa Via, Suite 140, Walnut Creek, CA 94598-3086 | 2014-03-20 |
| 1538413117 | Carrie Toni Chan | Nurse Practitioner | 106 La Casa Via, Suite 240, Walnut Creek, CA 94598-3086 | 2012-11-02 |
| 1609176478 | Justin Mark Keyashian | Dentist | 106 La Casa Via, 280, Walnut Creek, CA 94598-3086 | 2010-10-27 |
| 1275799124 | Haena Kim | Otolaryngology | 106 La Casa Via, Suite 200, Walnut Creek, CA 94598-3086 | 2008-07-31 |
| 1386786366 | Wayne R. Walker | Dentist | 106 La Casa Via, Suite 280, Walnut Creek, CA 94598-3086 | 2007-02-13 |
| 1942235411 | Anne M Thibault | Nurse Practitioner | 106 La Casa Via, Suite 100, Walnut Creek, CA 94598-3086 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467425439 | Ryan Alan Brown | Internal Medicine | 106 La Casa Via Ste 140, Walnut Creek, CA 94598-3084 | 2006-02-09 |
| 1942706569 | University Healthcare Alliance | Internal Medicine | 106 La Casa Via Ste 140, Walnut Creek, CA 94598-3084 | 2018-04-03 |
| 1992857700 | A. William Waibel | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2007-01-18 |
| 1245318302 | Christopher J. Forrest | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1124106224 | Sushil V. Karmarkar | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1154403533 | Sally Louise Davis | Internal Medicine | 2637 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2006-10-19 |
| 1689772360 | Timothy A Carlton | Internal Medicine | 1399 Ygnacio Valley Rd, Suite 11, Walnut Creek, CA 94598-2884 | 2006-09-20 |
| 1013947670 | Mark D Nathan | Internal Medicine | 106 La Casa Via, #140, Walnut Creek, CA 94598-3086 | 2006-07-03 |
| 1740210301 | John R Krouse | Internal Medicine | 106 La Casa Via, #140, Walnut Creek, CA 94598-3086 | 2006-07-03 |
| 1659301216 | Neal W White | Internal Medicine | 106 La Casa Via, #140, Walnut Creek, CA 94598-3086 | 2006-07-03 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
Please comment or provide details below to improve the information on CARDIOVASCULAR CONSULTANTS MEDICAL GROUP, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.