Organization
INNOVA PHYSICIAN NETWORK
Active
Parent organization
INNOVA PHYSICIAN NETWORK, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INNOVA PHYSICIAN NETWORK, INC
Authorized official
JOON PARK (DIRECTOR OF NETWORK DEVELOPMENT)
(323) 639-6593
Entity
Organization
Contact information
Practice address
1403 N. FAIR OAKS AVENUE, SUITE 3, PASADENA, CA 91103
(323) 639-6593
(626) 398-0357
Mailing address
1403 N. FAIR OAKS AVENUE, SUITE 3, PASADENA, CA 91103
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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