Provider Demographics
NPI:1437735115
Name:MONARCH CONCIERGE PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:MONARCH CONCIERGE PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-569-1287
Mailing Address - Street 1:8730 W SUNSET BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2210
Mailing Address - Country:US
Mailing Address - Phone:323-213-9263
Mailing Address - Fax:310-602-6529
Practice Address - Street 1:8730 W SUNSET BLVD STE 190
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-2210
Practice Address - Country:US
Practice Address - Phone:323-213-9263
Practice Address - Fax:310-602-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports MedicineGroup - Multi-Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Multi-Specialty