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Contact Information

EXECUTIVE MEDICAL GROUP LLC
1115 AQUA VISTA ST
UNIT 405
NORTH HOLLYWOOD, CA91602
 Phone: 310-381-9093
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Case Management

251B00000X
 

Hospice Care, Community Based

251G00000X B4[14] Hospice
 

In Home Supportive Care

253Z00000X
 

Nursing Care

251J00000X
Indicates primary specialty

NPI Profile & details for EXECUTIVE MEDICAL GROUP LLC

NPI Number 1194437707
LBN Legal business name EXECUTIVE MEDICAL GROUP LLC
Authorized official JEAN-CLAUDE KIARASH - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/15/2022
Last updated 12/15/2022 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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