Provider Demographics
NPI:1891479812
Name:PEDIATRIC GEMS, P.C.
Entity Type:Organization
Organization Name:PEDIATRIC GEMS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:G
Authorized Official - Last Name:SARRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-497-2161
Mailing Address - Street 1:955 CARRILLO DR STE 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5400
Mailing Address - Country:US
Mailing Address - Phone:310-888-7778
Mailing Address - Fax:310-888-7732
Practice Address - Street 1:955 CARRILLO DR STE 210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5400
Practice Address - Country:US
Practice Address - Phone:310-888-7778
Practice Address - Fax:310-888-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty