Organization
PACIFIC CREST HEALTHCARE INDEPENDENT PROVIDER ASSOCIATION, INC.
Active
Other names
Pacific Crest Healthcare IPA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROD AMIRI MD (ADMINISTRATOR)
(833) 724-4111
Entity
Organization
Contact information
Practice address
2601 AIRPORT DR STE 250, TORRANCE, CA 90505-6141
(833) 724-4111
Mailing address
2601 AIRPORT DR STE 250, TORRANCE, CA 90505-6141
(833) 724-4111
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4080636
CALIFORNIA SECRETARY OF STATE CORPORATION
CA
Enumeration date
11/18/2021
Last updated
07/24/2024
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