1437321288 NPI number — CALIFORNIA EM-I MEDICAL SERVICES

Table of content: (NPI 1437321288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437321288 NPI number — CALIFORNIA EM-I MEDICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA EM-I MEDICAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437321288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 41659
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19101-1659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-230-5160
Provider Business Mailing Address Fax Number:
805-564-5087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16453 COLORADO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARAMOUNT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90723-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-408-7409
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SLEPIN
Authorized Official First Name:
MARK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DIRECTOR/OFFICER
Authorized Official Telephone Number:
469-401-2386

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GR0083904 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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