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General NPI Number Information
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NPI Number | 1083916373
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Entity Type | Organization
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Legal Business Name | VALLEJO EMERGENCY PHYSICIANS MEDICAL GROUP INC.
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 300 HOSPITAL DRIVE
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City | VALLEJO
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State | CA
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Zip | 94589-2574
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Country | US
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Telephone | 330-493-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2545
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Country | US
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Telephone | 330-493-4443
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Fax | 330-493-8677
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN PETER MARON
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Credential | MD
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Telephone | 252-255-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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