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General NPI Number Information
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NPI Number | 1225080864
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Entity Type | Organization
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Legal Business Name | HISPANIC PHYSICIAN IPA MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 10503 VALLEY BLVD. SUITE 100
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City | EL MONTE
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State | CA
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Zip | 91731
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Country | US
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Telephone | 213-637-0925
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Fax | 213-355-8731
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Provider Business Mailing Address
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Address Line | PO BOX 255185
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City | SACRAMENTO
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State | CA
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Zip | 95865-5185
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Country | US
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Telephone | 213-596-7668
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Fax | 213-355-8731
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Authorized Official
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Title or Position | CEO
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Name | YVETTE BROWN
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Credential |
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Telephone | 213-521-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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