Provider Demographics
NPI:1235480583
Name:HEALTHCARE PARTNERS ASSOCIATES MEDICAL GROUP, P.C.
Entity Type:Organization
Organization Name:HEALTHCARE PARTNERS ASSOCIATES MEDICAL GROUP, P.C.
Other - Org Name:SEISMIC MEDICAL GROUP PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIETHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-205-6262
Mailing Address - Street 1:19191 S VERMONT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1018
Mailing Address - Country:US
Mailing Address - Phone:310-354-4211
Mailing Address - Fax:310-538-0671
Practice Address - Street 1:19191 S VERMONT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1018
Practice Address - Country:US
Practice Address - Phone:310-354-4211
Practice Address - Fax:310-538-0671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty