Provider Demographics
NPI:1699316695
Name:NEONATAL HOSPITALIST GROUP, INC
Entity type:Organization
Organization Name:NEONATAL HOSPITALIST GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-847-6332
Mailing Address - Street 1:9134 SEPULVEDA BLVD UNIT 2626
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91393-7032
Mailing Address - Country:US
Mailing Address - Phone:818-882-3430
Mailing Address - Fax:818-882-2466
Practice Address - Street 1:501 S BUENA VISTA ST NICU
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-847-6332
Practice Address - Fax:818-847-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASTATEMedicaid
CA232302Medicaid