Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pacific Heart and Vascular Medical Group

Organization Cardiovascular Disease Physician · NPI 1790712990

Pacific Heart and Vascular Medical Group is a Cardiovascular Disease Physician 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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