Organization
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMIN DAVIDOFF (EXECUTIVE MEDICAL DIRECTOR)
(877) 608-0044
Entity
Organization
Contact information
Practice address
43112 N 15TH ST, LANCASTER, CA 93534-6219
(661) 726-2279
Mailing address
393 E WALNUT ST, 3RD FLOOR, PHR GROUP & PROVIDER ENROLLMENT, PASADENA, CA 91188-0001
(626) 405-7914
(626) 406-4600
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
06/06/2008
Last updated
05/27/2021
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