Healthcare Provider Details

I. General information

NPI: 1700835816
Provider Name (Legal Business Name): CALIFORNIA EM-I MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 S FAIRMONT AVE
LODI CA
95240-5118
US

IV. Provider business mailing address

PO BOX 7830
PHILADELPHIA PA
19101-7830
US

V. Phone/Fax

Practice location:
  • Phone: 209-339-7575
  • Fax:
Mailing address:
  • Phone: 805-563-3011
  • 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: MARK J SLEPIN
Title or Position: DIRECTOR/OFFICER
Credential: MD
Phone: 469-401-2386