Provider Demographics
NPI:1134164882
Name:EL MONTE EMERGENCY MEDICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:EL MONTE EMERGENCY MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:AGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-350-7957
Mailing Address - Street 1:1701 SANTA ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-3482
Mailing Address - Country:US
Mailing Address - Phone:626-350-7957
Mailing Address - Fax:626-448-0485
Practice Address - Street 1:1701 SANTA ANITA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3482
Practice Address - Country:US
Practice Address - Phone:626-350-7957
Practice Address - Fax:626-448-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0095310Medicaid
CAHW17244Medicare PIN