Provider Demographics
NPI:1255629952
Name:ALAMEDA INDUSTRIAL MEDICAL GROUP
Entity type:Organization
Organization Name:ALAMEDA INDUSTRIAL MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-747-7667
Mailing Address - Street 1:1907 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-3206
Mailing Address - Country:US
Mailing Address - Phone:213-747-7667
Mailing Address - Fax:213-747-9618
Practice Address - Street 1:1907 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-3206
Practice Address - Country:US
Practice Address - Phone:213-747-7667
Practice Address - Fax:213-747-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000119744-0001-6261QP3300X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain