Provider Demographics
NPI:1346581402
Name:NATIONAL MEDICAL PHYSICIANS SERVICES GROUP LLC
Entity Type:Organization
Organization Name:NATIONAL MEDICAL PHYSICIANS SERVICES GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/E-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:714-566-5240
Mailing Address - Street 1:1433 W MERCED AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3402
Mailing Address - Country:US
Mailing Address - Phone:626-960-3066
Mailing Address - Fax:626-960-7937
Practice Address - Street 1:308 W CHAPMAN AVE UNIT 1936
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92856-7079
Practice Address - Country:US
Practice Address - Phone:714-566-5240
Practice Address - Fax:888-977-3286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA6257590OtherDL