Healthcare Provider Details

I. General information

NPI: 1801843917
Provider Name (Legal Business Name): ANAHEIM MEMORIAL HOSPITAL EMERGENCY PHYSICIANS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

PO BOX 10070
WESTMINSTER CA
92685-0070
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax:
Mailing address:
  • Phone: 562-809-3543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: IGNACIO ZARATE
Title or Position: PRESIDENT
Credential: MD
Phone: 562-809-3543