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General NPI Number Information
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NPI Number | 1548204787
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2800 BENEDICT DRIVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577
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Country | US
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Telephone | 510-357-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 POWELL STREET STE 920
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City | EMERYVILLE
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State | CA
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Zip | 94608-1803
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Country | US
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Telephone | 510-350-2777
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Fax |
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Authorized Official
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Title or Position | M.D
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Name | LESLIE ANGLADA
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Credential |
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Telephone | 510-350-2681
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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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