JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA INC. NPI 1104877208

NPI Information

  • NPI: 1104877208
  • Provider Name: JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC.
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Organization
  • Address: 18TH AVENUE AND HIGHWAY 53
    EMERGENCY DEPARTMENT
    CLEARLAKE, CA
    ZIP 95422
  • Phone: (707) 994-6486

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NPI Details

JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC. is an emergency medicine in Clearlake, CA. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. JJ&R EMERGENCY MEDICAL GROUP OF CALIFORNIA, INC. NPI is 1104877208. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18TH AVENUE AND HIGHWAY 53
EMERGENCY DEPARTMENT
CLEARLAKE, CA
ZIP 95422-720
Phone: (707) 994-6486
Fax: (707) 994-6075

The provider's authorized official is Barry B. Staum .
The authorized official title is President & Ceo and has the following contact phone number (310) 301-2030.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 11/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineG28196CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZZZ37653ZMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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