Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Pacific Heart and Vascular Medical Group

Organization Cardiovascular Disease Physician · NPI 1790712990

Pacific Heart and Vascular Medical Group provides Cardiovascular Disease Physician services in Lodi, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006

Practice location Address checks out

845 S Fairmont Ave Ste 11
Lodi, CA 95240-5113
Phone: (209) 334-0651
Fax: (209) 334-5013
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence FNP33233 (CA)

Record details

NPI number1790712990
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Katherine Bohna — Supervisor · (209) 464-3615
NPI enumeratedJune 26, 2006
Last updated in NPPESMarch 2, 2020
Certification dateMarch 2, 2020
Mailing address1801 E March Ln, Suite D400, Stockton, CA 95210-6629

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