MEDICARE: EMERGENCY AND ACUTE CARE MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1508818774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERGENCY AND ACUTE CARE MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 81243
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92138-1243
Country	:	US
Telephone Number	:	858-759-4765
Fax Number	:	858-759-8194

Provider Business Practice Location Address
First Line	:	1000 NUT TREE RD
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95687-4100
Country	:	US
Telephone Number	:	858-759-4765
Fax Number	:	858-759-8194

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	ARTHUR L GRUEN
Credential	:	MD
Telephone Number	:	858-759-4765

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	09/18/2007

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