Provider Demographics
NPI:1225172984
Name:ST. VINCENT IPA MEDICAL CORPORATIONS
Entity Type:Organization
Organization Name:ST. VINCENT IPA MEDICAL CORPORATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-7074
Mailing Address - Street 1:17215 STUDEBAKER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2548
Mailing Address - Country:US
Mailing Address - Phone:562-860-8771
Mailing Address - Fax:562-924-1603
Practice Address - Street 1:17215 STUDEBAKER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2548
Practice Address - Country:US
Practice Address - Phone:562-860-8771
Practice Address - Fax:562-924-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management