Basic Information
Provider Information
NPI: 1063656486
EntityType: 2
ReplacementNPI:  
OrganizationName: EMERGENCY CARE ASSOCIATES, INC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 4419
Address2:  
City: WOODLAND HILLS
State: CA
PostalCode: 913654419
CountryCode: US
TelephoneNumber: 8183409988
FaxNumber: 8185872493
Practice Location
Address1: 309 W BEVERLY BLVD
Address2:  
City: MONTEBELLO
State: CA
PostalCode: 906404308
CountryCode: US
TelephoneNumber: 3237261222
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2009
LastUpdateDate: 04/29/2009
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: GARCIA
AuthorizedOfficialFirstName: RICHARD
AuthorizedOfficialMiddleName: LUIS
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3237261222
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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