Healthcare Provider Details

I. General information

NPI: 1710939749
Provider Name (Legal Business Name): GIONIS EMERGENCY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2531
US

IV. Provider business mailing address

PO BOX 636082
CINCINNATI OH
45263-6082
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-6377
  • Fax:
Mailing address:
  • Phone: 954-377-2380
  • Fax: 865-291-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS A GIONIS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-864-6377