Organization Active NPI

Emergency Physicians of San Gabriel Valley

  • Emergency Medicine Physician
  • San Gabriel, CA
National Provider Identifier
1366021834
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY PHYSICIANS OF SAN GABRIEL VALLEY
Practice address
438 W Las Tunas Dr
San Gabriel, CA 91776-1216
Phone
(818) 340-9988
Fax
(818) 444-7214
NPI assigned
Apr 3, 2021
Last updated
Oct 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Jonathan Sturm
Title
Billing Manager
Phone
(818) 340-9988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

438 W Las Tunas Dr
San Gabriel, CA 91776-1216

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210507002497 CA Part B Supplier - Clinic/Group Practice 4082023726 Receives reassigned benefits from 41 practitioners
Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1366021834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9888",
            "fax_number": "818-444-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761216",
            "telephone_number": "818-340-9988",
            "fax_number": "818-444-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PHYSICIANS OF SAN GABRIEL VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "STURM",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "818-340-9988"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.