Petrel Emergency Physicians, a Medical Corporation
Organization Active NPI Emergency Medicine Physician · Marina del Rey, CA
NPI 1154734663 · NPPES record last updated Mar 30, 2023
Key facts
- NPI
- 1154734663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- PETREL EMERGENCY PHYSICIANS, A MEDICAL CORPORATION
- Practice address
- 4650 Lincoln Blvd
Marina del Rey, CA 90292-6306 - Phone
- (469) 401-2386
- NPI assigned
- Jun 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Karen Vaughn
- Title
- Officer
- Phone
- (973) 251-1132
Practitioners 85
-
Amy Adams, PA
-
Iman Afrooz, M.D
-
Rachel Akin, FNP
-
Nicole Carrie Albertson, PA-C
-
Ghazaleh Bahrami, M.D
-
Jill T Caratan, PAC
-
Clarence Matthew Chan, PA-C
-
Paul Coriolan, PAC
-
Sina Dadfarmay, MD
-
Jocylane Mateo Dinsay, N.P.
-
Danny Ali Dursun, M.D.
-
Soniya S Gandhi, MD
-
Jack Geoula, M,D.
-
Elham Ghadishah, M.D.
-
Narayana Rao Gunda, M.D.
-
Matthew Keener, PA-C
-
Jennifer R Kosova, PAC
-
Michelle Stephanie Koval, RPA-C
-
Steven Edward Lewis, PAC
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Mailing address
13737 Noel Rd
Ste 1600
Dallas, TX 75240-1331
Phone (954) 838-2371
NPI Registry JSON
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680134400000",
"number": "1154734663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13737 NOEL RD",
"address_2": "STE 1600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752401331",
"telephone_number": "954-838-2371",
"fax_number": "214-712-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926306",
"telephone_number": "469-401-2386"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PETREL EMERGENCY PHYSICIANS, A MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2014-06-03",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A",
"authorized_official_last_name": "VAUGHN",
"authorized_official_first_name": "KAREN",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "973-251-1132"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
- Justin Perez
- Stephanie Imelda Perez
- Kelsha Perine
- Colleen Perry
- Holly Peters
- Phalarope Inpatient Services, a Medical Corporation
- Jamie Phan
- Joseph Tri Phan
- Xavier Lamance Phillips
- Physiotherapy Associates, Inc
All providers in Marina del Rey, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.