Premier Emergency Physicians of California Medical Group PC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC

Practice address

465 W Putnam Ave
Porterville, CA 93257-3320

Phone

(559) 784-8886

Fax

(559) 791-4802

NPI assigned

Jul 16, 2007

Organization subpart

No

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 3

Addresses

Other identifiers 4

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1891994174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37655",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191010655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 W PUTNAM AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573320",
            "telephone_number": "559-784-8886",
            "fax_number": "559-791-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "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
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DH0325",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094164",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891994174",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ62867Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sitashi Poudyal, DDS
• Abimael Prado Jr., LCSW
• Heidi K Prado, P.A.
• Prairie Schooner Emergency Physicians, a Medical Corporation
• Brian Pratt
• Premier Pathology Laboratories
• Premier Pathology Laboratories Inc
• Alex Preston, MD
• Shelby L Pritchett, LVN
• Martha A. Prudencio, DDS

• All providers in Porterville, CA
• Emergency Medicine Physician in California

• 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.