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General NPI Number Information
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NPI Number | 1902292931
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Entity Type | Organization
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Legal Business Name | MEDICAL EMERGENCY CONSULTANTS OF CALIFORNIA, INC
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 6001 NORRIS CANYON RD
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City | SAN RAMON
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State | CA
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Zip | 94583-5400
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Country | US
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Telephone | 800-437-2672
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452165
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City | SUNRISE
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State | FL
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Zip | 33345-2165
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Country | US
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Telephone | 954-838-2371
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Fax |
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Authorized Official
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Title or Position | VP PROVIDER ENROLLMENT
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 973-251-1132
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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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