Healthcare Provider Details
I. General information
NPI: 1285938043
Provider Name (Legal Business Name): ALHAMBRA EMERGENCY MEDICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2011
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 S RAYMOND AVE
ALHAMBRA CA
91801-3166
US
IV. Provider business mailing address
PO BOX 4419
WOODLAND HILLS CA
91365-4419
US
V. Phone/Fax
- Phone: 626-570-1606
- Fax:
- Phone: 818-340-9988
- Fax: 818-587-2493
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
AGRON
Title or Position: PRESIDENT
Credential: MD
Phone: 909-629-8088