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Organization
GREATER TRI CITIES IPA
Active
Organization
GREATER TRI CITIES IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHI TOLIVER (ADMINISTRATOR)
(760) 941-7309
Entity
Organization
Contact information
Practice address
3923 WARING RD, SUITE D, OCEANSIDE, CA 92056-4457
(760) 941-7309
Mailing address
PO BOX 5059, OCEANSIDE, CA 92052-5059
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
05/25/2007
Last updated
01/08/2009
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