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General NPI Number Information
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NPI Number | 1356226690
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Entity Type | Organization
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Legal Business Name | CARDINAL EMERGENCY PROVIDERS PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1100 BUTTE ST
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City | REDDING
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State | CA
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Zip | 96001-0852
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Country | US
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Telephone | 530-244-5400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4419
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-4419
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Country | US
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Telephone | 818-340-9988
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN BIRNBAUM
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Credential | MD
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Telephone | 818-340-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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