# PACIFIC RIM ELECTROPHYSIOLOGY MEDICAL GRP, INC.

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

## Provider details

- **NPI number:** 1407859234
- **Authorized official:** CARLA M DREW (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (310) 672-9999

## Contact information

- **Practice address:** 1700 CESAR E. CHAVEZ AVENUE, SUITE 2700, LOS ANGELES, CA 90033-2434
- **Practice address phone:** (310) 672-9999
- **Practice address fax:** (310) 861-0540
- **Mailing address:** P.O. BOX 33679, LOS ANGELES, CA 90033-0679
- **Mailing address phone:** (310) 672-9999
- **Mailing address fax:** (310) 861-0540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | A32891 | CA | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | A32891 | CA | Yes |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | A81336 | CA | — |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 06/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0090210 | — | CA |