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General NPI Number Information
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NPI Number | 1942388947
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Entity Type | Organization
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Legal Business Name | NORWALK COMMUNITY EMERGENCY PHYSICIAN GROUP INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 13222 BLOOMFIELD AVE
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City | NORWALK
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State | CA
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Zip | 90650-3249
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Country | US
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Telephone | 562-864-8435
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12650
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City | WESTMINSTER
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State | CA
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Zip | 92685-2650
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Country | US
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Telephone | 562-809-3575
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Fax |
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. AMITABH PRAKASH
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Credential | MD
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Telephone | 562-864-8435
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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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