Premier Emergency Physicians of California Medical Group PC

Organization Active NPI Emergency Medicine Physician · Hollywood, CA

NPI 1831148071 · NPPES record last updated Apr 9, 2021

Key facts

NPI
1831148071
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC
Practice address
1300 N Vermont Ave
Hollywood, CA 90027-6005
Phone
(323) 913-4892
NPI assigned
May 6, 2006
Organization subpart
No

Authorized official

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

1300 N Vermont Ave
Hollywood, CA 90027-6005

Mailing address

PO Box 41969
Philadelphia, PA 19101-1969

Other identifiers

IdentifierTypeStateIssuer
ZZZ64757ZOtherCABLUE SHIELD OF CALIFORNIA
GR0094160MedicaidCA

Other providers in Hollywood, CA

All providers in Hollywood, CA · Emergency Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.