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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
2231 S WESTERN AVE, LOS ANGELES, CA 90018-1302
(323) 730-7300
Mailing address
PO BOX 37689, PHILADELPHIA, PA 19101-5289
(805) 564-5087
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265620959
—
CA
01
—
DA2094
RAILROAD
CA
05
—
GR0094163
—
CA
Enumeration date
10/09/2007
Last updated
04/09/2021
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