| NPI | 1164097341 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2021-05-20 |
| Last Updated | 2024-06-11 |
| Authorized Official | Jose Martinez Cardenas PRESIDENT/MEDICAL DIRECTOR Phone: 8187570954 |
| Mailing Address | 18518 Sherman Way Reseda, CA 91335-4212 United States Phone: (818) 757-0954 | Fax: (818) 757-0963 📍 View Map |
| Primary Practice Address | 290 E Verdugo Ave Ste 206 Burbank, CA 91502-1342 United States Phone: (818) 757-0954 | Fax: (818) 757-0963 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | CA | 05D1013422 | CLIA |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207R00000X – Internal Medicine | — | — |
| No | 208D00000X – General Practice | — | — |
| Yes | 261QP2300X – Clinic/Center, Primary Care | — | — |
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About NPI 1164097341
Cisco Medical Group, Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1164097341. The primary specialty listed is Clinic/Center, Primary Care. The organization is located in Burbank, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2021-05-20. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1164097341?
NPI 1164097341 belongs to Cisco Medical Group, Inc, a Clinic/Center, Primary Care in Burbank, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1164097341 active?
The current status of NPI 1164097341 in the NPPES registry is Active. The record was last updated on 2024-06-11.
What specialty is NPI 1164097341?
NPI 1164097341 is classified under the taxonomy Clinic/Center, Primary Care. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1164097341?
You can verify NPI 1164097341 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1164097341?
The primary practice address on file for NPI 1164097341 is 290 E Verdugo Ave Ste 206, Burbank, CA 91502-1342. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1164097341 issued?
NPI 1164097341 was first issued (enumerated) on 2021-05-20. The NPPES record was last updated on 2024-06-11.
Practice Location Map
Cisco Medical Group, Inc is located at 290 E Verdugo Ave Ste 206, Burbank, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Cisco Medical Group, Inc. All records sourced from the CMS NPPES registry.