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Organization
PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC
Active
Organization
PREMIER EMERGENCY PHYSICIANS OF CALIFORNIA MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
3001 SILLECT AVE, BAKERSFIELD, CA 93308-6337
(661) 316-6000
Mailing address
PO BOX 8069, PHILADELPHIA, PA 19101-8069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0094160
—
CA
01
—
ZZZ65818Z
BLUE SHIELD
CA
Enumeration date
05/09/2006
Last updated
04/09/2021
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