Organization
BRIDGE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ASHER YAKER (VICE PRESIDENT)
(800) 967-3309
Entity
Organization
Contact information
Practice address
15720 VENTURA BLVD, STE. 400, ENCINO, CA 91436-2914
(800) 967-3309
(800) 967-1138
Mailing address
P.O. BOX 1992, SANTA MONICA, CA 90406
(800) 967-3309
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2009
Last updated
05/21/2014
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