Organization
CITY OF ANGELS EMERGENCY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS ACOSTA M.D. (PRESIDENT)
(213) 989-6160
Entity
Organization
Contact information
Practice address
1711 W TEMPLE ST, LOS ANGELES, CA 90026-5421
(213) 989-6160
Mailing address
PO BOX 800817, SANTA CLARITA, CA 91380-0817
(661) 295-0859
(661) 295-0862
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
A25772
CA
2083X0100X
Occupational Medicine Physician
A25772
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A257720
—
CA
01
—
00A257720L72
CAL-OPTIMA ID#
CA
01
—
A25772
PRES. STATE LICENSE#
CA
05
—
GR0088360
—
CA
01
—
P00088664
RAILROAD MCARE ID#
CA
Enumeration date
10/27/2006
Last updated
11/29/2011
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