Provider Demographics
NPI:1548500192
Name:HIGH DESERT CARDIAC & MEDICAL CLINIC INC
Entity type:Organization
Organization Name:HIGH DESERT CARDIAC & MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUNASALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-241-2270
Mailing Address - Street 1:17868 US HIGHWAY 18
Mailing Address - Street 2:#102
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1267
Mailing Address - Country:US
Mailing Address - Phone:760-946-5177
Mailing Address - Fax:760-946-5133
Practice Address - Street 1:17868 US HIGHWAY 18
Practice Address - Street 2:#102
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1267
Practice Address - Country:US
Practice Address - Phone:760-946-5177
Practice Address - Fax:760-946-5133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHF176AMedicare PIN