Healthcare Provider Details

I. General information

NPI: 1831783729
Provider Name (Legal Business Name): SPECTRUM EMERGENCY PHYSICIANS GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 06/26/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

255 E SANTA CLARA ST STE 210
ARCADIA CA
91006-7233
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax:
Mailing address:
  • Phone: 626-240-8248
  • Fax: 626-493-2600

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: STANLEY TOY
Title or Position: OWNER
Credential: MD
Phone: 213-760-5542