NPIMap

Organization Active NPI

JJ&R Emergency Medical Group of California, Inc.

  • Emergency Medicine Physician
  • Simi Valley, CA
National Provider Identifier
1164473443
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
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
2975 Sycamore Dr
Emergency Department
Simi Valley, CA 93065-1201
Phone
(805) 955-6000
NPI assigned
May 12, 2006
Last updated
Nov 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X G28196 CA Primary

Addresses

Primary practice location

2975 Sycamore Dr
Emergency Department
Simi Valley, CA 93065-1201

Mailing address

1700 East Walnut Avenue
#250
El Segundo, CA 90245-2605
Phone (310) 301-2030

National Provider Directory

National Provider Directory

NPI Registry JSON

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": "1164473443",
    "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 SEGUNDO",
            "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": "2975 SYCAMORE DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651201",
            "telephone_number": "805-955-6000"
        }
    ],
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • 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.