Organization
ALTAMONT EMERGENCY PHYSICIANS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE MARIE CRAWFORD MD (PRESIDENT)
(209) 342-2300
Entity
Organization
Contact information
Practice address
1420 N TRACY BLVD, EMERGENCY DEPT, TRACY, CA 95376-3451
(209) 342-2300
(209) 524-4240
Mailing address
450 GLASS LN STE C, MODESTO, CA 95356-9287
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34916
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0044000
—
CA
01
—
ZZZ22800Z
BLUE SHIELD
CA
Enumeration date
11/03/2005
Last updated
04/19/2021
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