Healthcare Provider Details

I. General information

NPI: 1255654174
Provider Name (Legal Business Name): HOLLYWOOD HOSPITALIST MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE
LOS ANGELES CA
90027-6005
US

IV. Provider business mailing address

PO BOX 1190
ARCADIA CA
91077-1190
US

V. Phone/Fax

Practice location:
  • Phone: 313-913-4892
  • Fax:
Mailing address:
  • Phone: 626-447-0296
  • Fax: 626-447-6057

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 R. BELL
Title or Position: PHYSICIAN/MANAGING PARTNER
Credential: M.D.
Phone: 310-379-2134