# LAKEWOOD IPA, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAKEWOOD IPA, INC
- **Other names:** Fountain Valley IPA, Inc
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063896942
- **Legal business name:** LAKEWOOD IPA, INC
- **Authorized official:** MRS. VARSHA DESAI (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (562) 602-1563

## Contact information

- **Practice address:** 4909 LAKEWOOD BLVD STE 200, LAKEWOOD, CA 90712-2405
- **Practice address phone:** (562) 602-1563
- **Practice address fax:** (562) 529-8490
- **Mailing address:** 4909 LAKEWOOD BLVD STE 200, LAKEWOOD, CA 90712-2405
- **Mailing address phone:** (562) 602-1563
- **Mailing address fax:** (562) 529-8490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 07/10/2015