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General NPI Number Information
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NPI Number | 1659683720
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Entity Type | Organization
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Legal Business Name | FOOTHILL EMERGENCY MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 1900 SULLIVAN AVE
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City | DALY CITY
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State | CA
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Zip | 94015-2200
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Country | US
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Telephone | 650-992-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 515480
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City | LOS ANGELES
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State | CA
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Zip | 90051-6780
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Country | US
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Telephone | 877-346-2211
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Fax | 626-623-1227
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL S AGRON
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Credential | MD
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Telephone | 909-629-8088
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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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