Prominent Care Group Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G69486 Issued in CA

Legal business name

PROMINENT CARE GROUP INC

Practice address

11490 Burbank Blvd
Suite 6-C
N Hollywood, CA 91601-2389

Phone

(818) 633-4153

NPI assigned

Nov 18, 2008

Last updated

Nov 18, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan C Logan

Title

President

Phone

(818) 633-4153

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1053566141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11490 BURBANK BLVD",
            "address_2": "SUITE 6-C",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 BURBANK BLVD",
            "address_2": "SUITE 6-C",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012389",
            "telephone_number": "818-633-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMINENT CARE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-633-4153"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G69486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in N Hollywood, CA
• Providers in N Hollywood, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.