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NPI Code Detail

MEDICARE: WESTERN SIERRA EMERGENCY PHYSICIANS MEDICAL GROUP INC

MEDICARE: WESTERN SIERRA EMERGENCY PHYSICIANS MEDICAL GROUP INC
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881995272
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN SIERRA EMERGENCY PHYSICIANS MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 4535 DRESSLER RD NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2545
Country : US
Telephone Number : 855-687-0618
Fax Number : 330-493-8677
Provider Business Practice Location Address
First Line : 29100 HOSPITAL ROAD
Second Line :
City : LAKE ARROWHEAD
State : CA
Zip : 92352-9706
Country : US
Telephone Number : 855-687-0618
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : STEVEN P. MARON
Credential : M.D.
Telephone Number : 855-687-0618
Provider Enumeration Date : 11/16/2010
Last Update Date : 04/06/2022

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