Healthcare Provider Details

I. General information

NPI: 1972826931
Provider Name (Legal Business Name): HOLLYWOOD PRESBYTERIAN EMERGENCY MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
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 80358
CITY OF INDUSTRY CA
91716-8358
US

V. Phone/Fax

Practice location:
  • Phone: 310-321-0143
  • Fax:
Mailing address:
  • Phone: 310-321-0413
  • Fax: 310-379-4856

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: DR. IRV EDWARDS
Title or Position: PHYSICIAN/MANAGING PARTNER
Credential: M.D.
Phone: 310-321-0143