| Organization Name: | PACIFIC HEART AND VASCULAR MEDICAL GROUP |
| NPI Number: | 1962439463 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE ANNE POWELL (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 55 S Highway 26 Suite 1 Valley Springs |
| State: | CA US |
| Postal Code: | 952528422 |
| Phone Number: | 8778357938 |
| Fax Number: | 2094641311 |
| NPI Enumeration Date: | 06/28/2006 |
| NPI Last Update Date: | 01/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | FNP33233 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |