Provider Demographics
NPI:1164175907
Name:ALPINE PHYSICIAN PARTNERS, LLC
Entity Type:Organization
Organization Name:ALPINE PHYSICIAN PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:POOLE
Authorized Official - Last Name:WING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-810-1948
Mailing Address - Street 1:469 S CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5807
Mailing Address - Country:US
Mailing Address - Phone:314-712-0261
Mailing Address - Fax:
Practice Address - Street 1:502 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4660
Practice Address - Country:US
Practice Address - Phone:659-213-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty