Organization
HERITAGE PROVIDER NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA COURTNEY (DIRECTOR OF FFS)
(661) 726-3805
Entity
Organization
Contact information
Practice address
8510 BALBOA BLVD, SUITE 275, NORTHRIDGE, CA 91325-3583
(818) 654-3400
(818) 654-3460
Mailing address
PO BOX 7007, LANCASTER, CA 93539-7007
(661) 726-3805
(661) 726-3862
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
09/20/2007
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