# PROMINENT CARE GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053566141
- **Authorized official:** SUSAN C LOGAN (PRESIDENT)
- **Authorized official phone:** (818) 633-4153

## Contact information

- **Practice address:** 11490 BURBANK BLVD, SUITE 6-C, N HOLLYWOOD, CA 91601-2389
- **Practice address phone:** (818) 633-4153
- **Mailing address:** 11490 BURBANK BLVD, SUITE 6-C, N HOLLYWOOD, CA 91601-2389

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | G69486 | CA | Yes |

## Other

- **Enumeration date:** 11/18/2008
- **Last updated:** 11/18/2008