# PREMIERONE PLUS IDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922841311
- **Authorized official:** MR. JAY CHOI (CEO)
- **Authorized official phone:** (213) 434-0999

## Contact information

- **Practice address:** 6800 LINCOLN AVE, SUITE 200, BUENA PARK, CA 90620
- **Practice address phone:** (714) 495-4392
- **Practice address fax:** (714) 388-3354
- **Mailing address:** 6800 LINCOLN AVE, SUITE 200, BUENA PARK, CA 90620
- **Mailing address phone:** (714) 495-4392
- **Mailing address fax:** (714) 388-3354

## Taxonomy

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

## Other

- **Enumeration date:** 06/14/2024
- **Last updated:** 06/14/2024