Whalio Doctors

NPI 1053604454

Avante Best Care Ipa

Organisation Exclusive Provider Organization San Marino, CA

Practice location

Address
2360 Huntington Dr STE 201, San Marino, CA 91108-2651
Phone
(626) 656-2370
Fax
(626) 248-9060

Authorised official

Name
Lan Nhu Bich Phan
Title
Administrator
Phone
(626) 656-2370

Registered specialties

Exclusive Provider Organization Primary
Managed Care Organizations Taxonomy 302F00000X

Registry record

NPI
1053604454
Entity type
Organization
NPI issued
18 May 2011
Record last updated
18 May 2011

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.