Healthcare Provider Details

I. General information

NPI: 1801837661
Provider Name (Legal Business Name): TEMPLE DOCTORS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N VIRGIL AVE SUITE 6
LOS ANGELES CA
90004-5399
US

IV. Provider business mailing address

2080 OUTRIGGER DR
EL DORADO HILLS CA
95762-3755
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-4211
  • Fax: 213-382-4268
Mailing address:
  • Phone: 916-941-7744
  • Fax: 213-382-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDALL WEST
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 213-382-4211