Provider Demographics
NPI:1164960126
Name:PERFECT HEALTH CARE,IPA,INC
Entity Type:Organization
Organization Name:PERFECT HEALTH CARE,IPA,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANAGASABAI
Authorized Official - Middle Name:
Authorized Official - Last Name:KANAKESWARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-942-9072
Mailing Address - Street 1:1601 W AVENUE J
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2824
Mailing Address - Country:US
Mailing Address - Phone:661-942-9072
Mailing Address - Fax:661-855-4677
Practice Address - Street 1:1601 W AVENUE J
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2824
Practice Address - Country:US
Practice Address - Phone:661-942-9072
Practice Address - Fax:661-855-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty