La Jolla Emergency Enterprises, Inc. | |
1101 N. Pacific Ave. Suite 104 Glendale CA 91202-4313 | |
(818) 552-5000 | |
(818) 956-0990 |
Full Name | La Jolla Emergency Enterprises, Inc. |
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Speciality | Internal Medicine |
Location | 1101 N. Pacific Ave., Glendale, California |
Authorized Official Name and Position | Talal Abdullah Al-quraini (PRESIDENT/OWNER) |
Authorized Official Contact | 8583618004 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
La Jolla Emergency Enterprises, Inc. 6136 Cardeno Dr La Jolla CA 92037-6924 Ph: (858) 361-8004 | La Jolla Emergency Enterprises, Inc. 1101 N. Pacific Ave. Suite 104 Glendale CA 91202-4313 Ph: (818) 552-5000 |
NPI Number | 1447532650 |
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Provider Enumeration Date | 09/13/2011 |
Last Update Date | 03/04/2013 |
Medicare PECOS PAC ID | 9537327374 |
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Medicare Enrollment ID | O20120223000995 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447532650 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | A61433 (California) | Primary |
Provider Name | Talal A Al-quraini |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1316955446 PECOS PAC ID: 9537264031 Enrollment ID: I20070411000338 |
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