NPI 1124441696

Imperial Health Holdings, a Professional Medical Corporation

Organisation Exclusive Provider Organization San Marino, CA

Practice location

Address: 2295 Huntington Dr # D, San Marino, CA 91108-2640
Phone: (626) 656-2370
Fax: (626) 248-9060

Authorised official

Name: Lan Nhu Bich Phan
Title: Admistrator
Phone: (818) 399-8996

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in California →

Registry record

NPI: 1124441696
Entity type: Organization
NPI issued: 3 Feb 2014
Record last updated: 3 Feb 2014

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.