Healthcare Provider Details
I. General information
NPI: 1508022245
Provider Name (Legal Business Name): CALIFORNIA EM-I MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2008
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2131 W 3RD ST
LOS ANGELES CA
90057-1901
US
IV. Provider business mailing address
3916 STATE ST SUITE 300
SANTA BARBARA CA
93105-5602
US
V. Phone/Fax
- Phone: 213-484-7901
- Fax:
- Phone: 805-563-3011
- Fax: 805-564-5087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANGEL
L
ISCOVICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-563-3011