Provider Demographics
NPI:1922241843
Name:DOCTORS MANAGED EMERGENCY MEDICAL GROUP INC.
Entity type:Organization
Organization Name:DOCTORS MANAGED EMERGENCY MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAGASAMUDRA
Authorized Official - Middle Name:SHAMARAO
Authorized Official - Last Name:ASHOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-515-2309
Mailing Address - Street 1:851 W MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1047
Mailing Address - Country:US
Mailing Address - Phone:818-243-0008
Mailing Address - Fax:626-579-0060
Practice Address - Street 1:851 W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-1047
Practice Address - Country:US
Practice Address - Phone:818-243-0008
Practice Address - Fax:626-579-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty