Provider Demographics
NPI:1215268479
Name:PRIMA HEART, A MEDICAL GROUP
Entity type:Organization
Organization Name:PRIMA HEART, A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SOTERIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KARAHALIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-333-1345
Mailing Address - Street 1:PO BOX 3037
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-3037
Mailing Address - Country:US
Mailing Address - Phone:559-436-0871
Mailing Address - Fax:559-435-5221
Practice Address - Street 1:1010 CASS ST
Practice Address - Street 2:A-2
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4515
Practice Address - Country:US
Practice Address - Phone:831-333-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty