NPIMap

Organization Active NPI

California Emergency Physician Medical Group

  • Physician Assistant
  • Montebello, CA
National Provider Identifier
1629359864
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
CALIFORNIA EMERGENCY PHYSICIAN MEDICAL GROUP
Practice address
615 W Lincoln Ave
Montebello, CA 90640-3528
Phone
(323) 727-0205
NPI assigned
Sep 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

Name
Kim Yen Pham, PA-C
Title
Mid Level Practitioner
Phone
(323) 727-0205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

615 W Lincoln Ave
Montebello, CA 90640-3528

Mailing address

615 W Lincoln Ave
Montebello, CA 90640-3528
Phone (323) 727-0205

National Provider Directory

National Provider Directory
Tax ID family
California Emergency Sa22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1629359864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W LINCOLN AVE",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403528",
            "telephone_number": "323-727-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W LINCOLN AVE",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403528",
            "telephone_number": "323-727-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA EMERGENCY PHYSICIAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "YEN",
        "authorized_official_title_or_position": "MID LEVEL PRACTITIONER",
        "authorized_official_telephone_number": "323-727-0205",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.