NPIMap

Organization Active NPI

Tarzana Emergency Medical Associates

  • Emergency Medicine Physician
  • Tarzana, CA
National Provider Identifier
1235176702
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TARZANA EMERGENCY MEDICAL ASSOCIATES
Practice address
18321 Clark St
Tarzana, CA 91356-3501
Phone
(310) 321-0143
Fax
(818) 705-2595
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Irv E Edwards
Title
Owner
Phone
(310) 321-0143

Specialties & licenses 1

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

Addresses

Primary practice location

18321 Clark St
Tarzana, CA 91356-3501

Mailing address

PO Box 80676
City of Industry, CA 91716-8414
Phone (310) 321-0413

Other identifiers 1

IdentifierTypeStateIssuer
GR0090200MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708001387 CA Part B Supplier - Clinic/Group Practice 7113823014 Receives reassigned benefits from 74 practitioners
Practice locations: Tarzana, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1235176702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80676",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168414",
            "telephone_number": "310-321-0413",
            "fax_number": "310-379-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "310-321-0143",
            "fax_number": "818-705-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARZANA EMERGENCY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "IRV",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-321-0143"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.