Provider Demographics
NPI:1083645352
Name:HOSPITAL SPECIALIST GROUP, INC.
Entity Type:Organization
Organization Name:HOSPITAL SPECIALIST GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ECARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-489-4261
Mailing Address - Street 1:345 S HALCYON RD
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3896
Mailing Address - Country:US
Mailing Address - Phone:805-489-4261
Mailing Address - Fax:805-994-5415
Practice Address - Street 1:345 S HALCYON RD
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3896
Practice Address - Country:US
Practice Address - Phone:805-489-4261
Practice Address - Fax:805-994-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0099740Medicaid
CAW18382Medicare PIN