Organization
IN PHYSICIAN ASSOCIATES, A PROFESSIONAL MEDICAL CORPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LI (DIRECTOR OF CONFIGURATION)
(323) 579-0703
Entity
Organization
Contact information
Practice address
6119 E WASHINGTON BLVD STE 201, COMMERCE, CA 90040-2452
(323) 899-8283
Mailing address
6119 E WASHINGTON BLVD STE 201, COMMERCE, CA 90040-2452
(323) 899-8283
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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