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Organization

PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC

Active
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Organization

PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY KONDAS (OFFICER)
(943) 251-1132
Entity
Organization

Contact information

Practice address
240 SPRUCE ST, GRIDLEY, CA 95948-2216
(530) 846-9021
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
(214) 712-2444

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0094160
—
CA
01
—
ZZZ65982Z
BLUE SHIELD
CA
Enumeration date
05/09/2006
Last updated
04/09/2021
About Stedi
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