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) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ64757Z | Other | CA | BLUE SHIELD OF CALIFORNIA |
| GR0094160 | Medicaid | CA |
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All providers in Hollywood, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.