1376305755 NPI number — EM ALLIANCE CALIFORNIA, APC

Table of content: (NPI 1376305755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376305755 NPI number — EM ALLIANCE CALIFORNIA, APC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EM ALLIANCE CALIFORNIA, APC
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:
1376305755
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2326 S CONGRESS AVE STE 2D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33406-7614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-203-0611
Provider Business Mailing Address Fax Number:
561-203-1992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25500 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRIETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92562-5965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-951-9886
Provider Business Practice Location Address Fax Number:
561-203-1992
Provider Enumeration Date:
01/30/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROMBERG
Authorized Official First Name:
ADAM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
561-203-0611

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)