Organization
CENTURY EMERGENCY MEDICAL GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES V PAGANO MD (PRESIDENT)
(909) 599-6811
Entity
Organization
Contact information
Practice address
1350 W COVINA BLVD, SAN DIMAS, CA 91773-3245
(909) 599-6811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(800) 358-9787
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC9167
RAILROAD MEDICARE
CA
05
—
GR0066610
—
CA
05
—
GR0066611
—
CA
01
—
ZZZ47634Z
BLUE SHIELD
CA
01
—
ZZZ52054Z
BLUE SHIELD
CA
Enumeration date
05/19/2006
Last updated
08/22/2020
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