Provider Demographics
NPI:1508818774
Name:EMERGENCY AND ACUTE CARE MEDICAL CORPORATION
Entity Type:Organization
Organization Name:EMERGENCY AND ACUTE CARE MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-759-4765
Mailing Address - Street 1:PO BOX 81243
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92138-1243
Mailing Address - Country:US
Mailing Address - Phone:858-759-4765
Mailing Address - Fax:858-759-8194
Practice Address - Street 1:1000 NUT TREE RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4100
Practice Address - Country:US
Practice Address - Phone:858-759-4765
Practice Address - Fax:858-759-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0058099Medicaid
CAZZZ37433ZMedicare ID - Type Unspecified