Provider Demographics
NPI:1366567273
Name:HEART & HYPERTENSION HEALTH MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:HEART & HYPERTENSION HEALTH MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MODLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-375-5801
Mailing Address - Street 1:1000 NEWBURY RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6445
Mailing Address - Country:US
Mailing Address - Phone:805-375-5801
Mailing Address - Fax:805-375-5080
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:SUITE 270
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6445
Practice Address - Country:US
Practice Address - Phone:805-375-5801
Practice Address - Fax:805-375-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG014555207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89219Medicare UPIN
CAW19716Medicare ID - Type Unspecified