Healthcare Provider Details

I. General information

NPI: 1013646439
Provider Name (Legal Business Name): TPIRC MEDICAL FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 28TH ST STE 418
LONG BEACH CA
90806-2794
US

IV. Provider business mailing address

PO BOX 2246
SEAL BEACH CA
90740-1246
US

V. Phone/Fax

Practice location:
  • Phone: 562-490-9900
  • Fax: 562-317-1387
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANOOP LOHARA
Title or Position: COO
Credential:
Phone: 805-501-6217