Healthcare Provider Details

I. General information

NPI: 1013343631
Provider Name (Legal Business Name): ARCADIA METHODIST, IPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 S SANTA ANITA AVE
ARCADIA CA
91006-3521
US

IV. Provider business mailing address

1668 S GARFIELD AVE
ALHAMBRA CA
91801-5400
US

V. Phone/Fax

Practice location:
  • Phone: 626-232-5898
  • Fax:
Mailing address:
  • Phone: 626-282-0288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: JAMES LIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-232-5898