Provider Demographics
NPI:1861719668
Name:ADVANCED CARDIO SERVICES
Entity type:Organization
Organization Name:ADVANCED CARDIO SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-803-8635
Mailing Address - Street 1:2544 CAMPBELL PL
Mailing Address - Street 2:SUITE 275
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-1752
Mailing Address - Country:US
Mailing Address - Phone:866-416-8989
Mailing Address - Fax:866-416-8970
Practice Address - Street 1:2544 CAMPBELL PL
Practice Address - Street 2:SUITE 275
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-1752
Practice Address - Country:US
Practice Address - Phone:866-416-8989
Practice Address - Fax:866-416-8970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAER345A291U00000X, 293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No291U00000XLaboratoriesClinical Medical Laboratory