Healthcare Provider Details

I. General information

NPI: 1649229600
Provider Name (Legal Business Name): CALIFORNIA EM-I MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 CESAR CHAVEZ
SAN FRANCISCO CA
94110-4403
US

IV. Provider business mailing address

3916 STATE ST SUITE 300
SANTA BARBARA CA
93105-5602
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-6625
  • Fax:
Mailing address:
  • Phone: 805-563-3011
  • Fax:

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 Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGEL L. ISCOVICH
Title or Position: PRESIDENT
Credential: MD
Phone: 805-563-3011