Organization
KING DREW MEDICAL FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE EPPS (CEO)
(310) 668-3802
Entity
Organization
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 669-3802
Mailing address
3605 LONG BEACH BLVD, SUITE 426, LONG BEACH, CA 90807-4013
(562) 427-5363
(562) 427-8802
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M050578
GROUP BILLING NUMBER
CA
Enumeration date
09/17/2006
Last updated
08/22/2020
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