NPI 1043242563

Southern California Permanente Medical Group

Organisation Health Maintenance Organization Los Angeles, CA

Practice location

Address: 6041 Cadillac Ave, Los Angeles, CA 90034-1702
Phone: (323) 857-2000
Mailing address: 393 E Walnut St 3rd Fl Phr Group & Provider Enrollment, Pasadena, CA 91188-0001

Authorised official

Name: Ramin Davidoff
Title: Executive Medical Director
Phone: (877) 608-0044

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1043242563
Entity type: Organization
NPI issued: 7 Jul 2006
Record last updated: 2 Nov 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.