PROSPECT MEDICAL GROUP AZ INC. NPI 1366037152

NPI Information

NPI: 1366037152
Provider Name: PROSPECT MEDICAL GROUP AZ, INC.
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3415 S SEPULVEDA BLVD FL 9
LOS ANGELES, CA
ZIP 90034
Phone: (310) 943-4500
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PROSPECT MEDICAL GROUP AZ, INC. is a general practice in Los Angeles, CA. PROSPECT MEDICAL GROUP AZ, INC. NPI is 1366037152. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3415 S SEPULVEDA BLVD FL 9
LOS ANGELES, CA
ZIP 90034-060
Phone: (310) 943-4500

The provider's authorized official is Robert Elders .
The authorized official title is Secretary and has the following contact phone number (310) 943-4500.

The enumeration date for this NPI number is 3/4/2021 and was last updated on 3/4/2021.

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
1	208D00000X	General Practice				Yes

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: 11/14/2023

NPI Synchronization or Removal

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