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General NPI Number Information
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NPI Number | 1174808802
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Entity Type | Organization
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Legal Business Name | PARTNERS IN MEDICINE
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 481 PLUMAS BLVD #104
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City | YUBA CITY
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State | CA
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Zip | 95991-5075
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Country | US
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Telephone | 530-671-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N SEPULVEDA BLVD SUITE 600
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4359
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Country | US
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Telephone | 310-320-3990
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/NETWORK STRATEGY
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Name | PAUL WALES
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Credential |
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Telephone | 951-788-3577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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