Organization
PREMIERCARE IPA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WONG (CHAIRMAN OF THE BOARD)
(562) 766-2000
Entity
Organization
Contact information
Practice address
5000 AIRPORT PLAZA DR STE 150, LONG BEACH, CA 90815-1275
(562) 766-2000
(562) 766-2008
Mailing address
5000 AIRPORT PLAZA DR STE 150, LONG BEACH, CA 90815-1275
(562) 766-2000
(562) 766-2008
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
FNP40625
CA
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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