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Organization
PEDIATRIC ACUTE CARE MEDICAL ASSOCIATES, INC.
Active
Organization
PEDIATRIC ACUTE CARE MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMEN JULIA BOTERO MD (MEDICAL DIRECTOR)
(818) 788-5437
Entity
Organization
Contact information
Practice address
5353 BALBOA BLVD, SUITE 201, ENCINO, CA 91316-2804
(818) 788-5437
(818) 788-5436
Mailing address
PO BOX 571027, TARZANA, CA 91357-1027
(818) 788-5437
(818) 788-5436
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A47742
CA
2080P0202X
Pediatric Cardiology Physician
A47742
CA
2080P0203X
Pediatric Critical Care Medicine Physician
A47742
CA
Other
Enumeration date
11/28/2006
Last updated
10/17/2012
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