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General NPI Number Information
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NPI Number | 1962705764
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Entity Type | Organization
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Legal Business Name | REDWOOD GENERAL EMERGENCY PHYSICIANS MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 2400 S FLOWER ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-2629
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Country | US
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Telephone | 213-742-1162
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2801
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City | LONG BEACH
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State | CA
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Zip | 90801-2801
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Country | US
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Telephone | 562-468-0227
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN P. MARON
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Credential | MD
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Telephone | 925-225-5837
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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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