Provider Demographics
NPI:1639275670
Name:ACADEMIC HOSPITALISTS MEDICAL GROUP
Entity Type:Organization
Organization Name:ACADEMIC HOSPITALISTS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VAIBHAV
Authorized Official - Middle Name:MADHUKAR
Authorized Official - Last Name:ANVEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-644-2343
Mailing Address - Street 1:50 BELLEFONTAINE ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3132
Mailing Address - Country:US
Mailing Address - Phone:626-795-0411
Mailing Address - Fax:626-795-0080
Practice Address - Street 1:50 BELLEFONTAINE ST
Practice Address - Street 2:SUITE 307
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3132
Practice Address - Country:US
Practice Address - Phone:626-795-0411
Practice Address - Fax:626-795-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty