Provider Demographics
NPI:1598122871
Name:PRIMARY CARE HEALTH NETWORK LLC
Entity Type:Organization
Organization Name:PRIMARY CARE HEALTH NETWORK LLC
Other - Org Name:INTEGRATED HEALTH PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-542-4343
Mailing Address - Street 1:7535 METROPOLITAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4402
Mailing Address - Country:US
Mailing Address - Phone:619-542-4300
Mailing Address - Fax:619-542-4377
Practice Address - Street 1:7535 METROPOLITAN DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4402
Practice Address - Country:US
Practice Address - Phone:619-542-4300
Practice Address - Fax:619-542-4377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNCIL OF COMMUNITY CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management