JJ&R Emergency Medical Group of California, Inc.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G28196 Issued in CA

Legal business name

JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC.

Practice address

7300 Medical Center Dr
Emergency Department
West Hills, CA 91307-1902

Phone

(818) 676-4000

Fax

(818) 704-3880

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Barry B. Staum, M.D.

Title

President &Ceo

Phone

(310) 301-2030

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1083665293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 EAST WALNUT AVENUE",
            "address_2": "#250",
            "city": "EL SAGUNDO",
            "state": "CA",
            "postal_code": "902452605",
            "telephone_number": "310-301-2030",
            "fax_number": "310-306-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MEDICAL CENTER DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071902",
            "telephone_number": "818-676-4000",
            "fax_number": "818-704-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "STAUM",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT &CEO",
        "authorized_official_telephone_number": "310-301-2030",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G28196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0056146",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in West Hills, CA
• Providers in West Hills, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.