Provider Demographics
NPI:1790128114
Name:APOLLOMED EMERGENCY MEDICINE MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:APOLLOMED EMERGENCY MEDICINE MANAGEMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-839-5200
Mailing Address - Street 1:PO BOX 4555
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91222-0555
Mailing Address - Country:US
Mailing Address - Phone:818-839-5200
Mailing Address - Fax:818-839-5190
Practice Address - Street 1:9449 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1421
Practice Address - Country:US
Practice Address - Phone:818-839-5200
Practice Address - Fax:818-839-5190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APOLLO MEDICAL MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69768208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty