Healthcare Provider Details

I. General information

NPI: 1699316695
Provider Name (Legal Business Name): NEONATAL HOSPITALIST GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST NICU
BURBANK CA
91505-4809
US

IV. Provider business mailing address

9134 SEPULVEDA BLVD UNIT 2626
NORTH HILLS CA
91393-7032
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-6332
  • Fax: 818-847-6339
Mailing address:
  • Phone: 818-882-3430
  • Fax: 818-882-2466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT GALL
Title or Position: PARTNER
Credential: MD
Phone: 818-847-6332