Organization
CALIFORNIA HEALTHFIRST PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PERKO (CFO)
(909) 335-7171
Entity
Organization
Contact information
Practice address
501 N ORANGE ST, SUITE 200, GLENDALE, CA 91203-1911
(818) 291-9747
(818) 662-9685
Mailing address
PO BOX 10968, SAN BERNARDINO, CA 92423-0968
(909) 335-7171
(909) 335-7140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316113145
—
CA
01
—
ZZZ54049Y
BS/TRIWEST
CA
Enumeration date
05/01/2008
Last updated
07/13/2009
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