Provider Demographics
NPI:1992714471
Name:NAPA VALLEY CARDIAC AND THORACIC SURGERY, INCORPORATED
Entity type:Organization
Organization Name:NAPA VALLEY CARDIAC AND THORACIC SURGERY, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLINGMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:707-254-9640
Mailing Address - Street 1:3421 VILLA LN
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3056
Mailing Address - Country:US
Mailing Address - Phone:707-254-9640
Mailing Address - Fax:707-254-9698
Practice Address - Street 1:3421 VILLA LN
Practice Address - Street 2:SUITE 2A
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3056
Practice Address - Country:US
Practice Address - Phone:707-254-9640
Practice Address - Fax:707-254-9698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092770Medicaid
CADA8135Medicare ID - Type UnspecifiedGROUP RAILROAD MEDICARE
CAGR0092770Medicaid