Organization Active NPI

Premier Emergency Physicians of California Medical Group PC

  • Emergency Medicine Physician
  • King City, CA
National Provider Identifier
1326222456
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC
Practice address
300 Canal St
King City, CA 93930-3431
Phone
(831) 385-6000
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Kathy Kondas
Title
Officer
Phone
(973) 251-1132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

300 Canal St
King City, CA 93930-3431

Mailing address

PO Box 37703
Philadelphia, PA 19101-5103
Phone (800) 355-0808

Other identifiers 1

IdentifierTypeStateIssuer
1326222456MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1326222456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37703",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191015103",
            "telephone_number": "800-355-0808",
            "fax_number": "610-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CANAL ST",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303431",
            "telephone_number": "831-385-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHY",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326222456",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.