Healthcare Provider Details

I. General information

NPI: 1912000936
Provider Name (Legal Business Name): FREEMAN EMERGENCY PHYSICIANS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N PRAIRIE AVE
INGLEWOOD CA
90301-4501
US

IV. Provider business mailing address

PO BOX 10130
WESTMINSTER CA
92685-0130
US

V. Phone/Fax

Practice location:
  • Phone: 310-674-7050
  • Fax:
Mailing address:
  • Phone:
  • 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: MAXINE BARRETT
Title or Position: PARTNER
Credential: MD
Phone: 562-809-3544