Basic Information
| Provider Information | |||||||||
| NPI: | 1538897590 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA CONCIERGE PHYSICIANS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 681 ORANGEBURGH RD | ||||||||
| Address2: | |||||||||
| City: | RIVER VALE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076756404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162871120 | ||||||||
| FaxNumber: | 8884115515 | ||||||||
| Practice Location | |||||||||
| Address1: | 11333 MOORPARK STREET | ||||||||
| Address2: | SUITE 16 | ||||||||
| City: | STUDIO CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8339990090 | ||||||||
| FaxNumber: | 8004115515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2022 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | BARSOUMIAN | ||||||||
| AuthorizedOfficialFirstName: | RAFFI | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5162871120 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.