Organization Name: | CARDIO CARE PRACTICE LLC |
NPI Number: | 1669856795 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MOHAMMAD REZA MOVAHED SHARIAT PANAHI (MANAGER) |
Mailing Address: | 6119 N Pinchot Rd Tucson |
State: | AZ US |
Postal Code: | 857501297 |
Phone Number: | 5203034572 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2015 |
NPI Last Update Date: | 07/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | A35065 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |