Organization
MAXIMED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB TCHAMANIAN (CEO)
(562) 264-2800
Entity
Organization
Contact information
Practice address
320 GOLDEN SHR, SUITE # 200, LONG BEACH, CA 90802-4243
(562) 264-2800
(562) 264-2558
Mailing address
320 GOLDEN SHR, SUITE # 200, LONG BEACH, CA 90802-4243
(562) 264-2800
(562) 264-2558
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M3428
HEALTH NET
CA
Enumeration date
07/26/2010
Last updated
07/26/2010
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