# BEVERLY ALLIANCE IPA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BEVERLY ALIANZA IPA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598131450
- **Authorized official:** KHALID NUR M.D. (CEO)
- **Authorized official phone:** (714) 495-4392

## Contact information

- **Practice address:** 17215 STUDEBAKER RD STE 331, CERRITOS, CA 90703-2557
- **Practice address phone:** (714) 495-4392
- **Mailing address:** 17215 STUDEBAKER RD STE 331, CERRITOS, CA 90703-2557
- **Mailing address phone:** (714) 495-4392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | C3776980 | CA | Yes |

## Other

- **Enumeration date:** 08/14/2015
- **Last updated:** 08/14/2015