HEALTHCARE PARTNERS AFFILIATES MEDICAL GROUP

Provider Demographics

• NPI: 1659312593
• Name: HEALTHCARE PARTNERS AFFILIATES MEDICAL GROUP
• Entity type: Organization
• Organization Name: HEALTHCARE PARTNERS AFFILIATES MEDICAL GROUP
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: MANAGER
• Authorized Official - First Name: A
• Authorized Official - Last Name: FAVORS
• Authorized Official - Phone: 310-525-3847
• Mailing Address - Street 1: P.O. BOX 6400
• Mailing Address - City: TORRANCE
• Mailing Address - State: CA
• Mailing Address - Zip Code: 90504-6400
• Mailing Address - Country: US
• Mailing Address - Phone: 310-525-3847
• Mailing Address - Fax: 310-783-5582
• Practice Address - Street 1: 1120 W WASHINGTON BLVD
• Practice Address - City: LOS ANGELES
• Practice Address - State: CA
• Practice Address - Zip Code: 90015-3316
• Practice Address - Country: US
• Practice Address - Phone: 213-623-2225
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-06-10
• Last Update Date: 2024-09-20

Provider Licenses

State	License ID	Taxonomies
		207L00000X, 204C00000X, 207K00000X, 207N00000X, 207Q00000X, 207QA0505X, 207RE0101X, 207U00000X, 207VG0400X, 207VM0101X, 207W00000X, 207RC0000X, 207Y00000X, 207R00000X
CA	BU20504720	261QA1903X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207L00000X	Allopathic & Osteopathic Physicians	Anesthesiology		Group - Multi-Specialty
No	204C00000X	Allopathic & Osteopathic Physicians	Neuromusculoskeletal Medicine, Sports Medicine		Group - Multi-Specialty
No	207K00000X	Allopathic & Osteopathic Physicians	Allergy & Immunology		Group - Multi-Specialty
No	207N00000X	Allopathic & Osteopathic Physicians	Dermatology		Group - Multi-Specialty
No	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207QA0505X	Allopathic & Osteopathic Physicians	Family Medicine	Adult Medicine	Group - Multi-Specialty
No	207RE0101X	Allopathic & Osteopathic Physicians	Internal Medicine	Endocrinology, Diabetes & Metabolism	Group - Multi-Specialty
No	207U00000X	Allopathic & Osteopathic Physicians	Nuclear Medicine		Group - Multi-Specialty
No	207VG0400X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	Gynecology	Group - Multi-Specialty
No	207VM0101X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	Maternal & Fetal Medicine	Group - Multi-Specialty
No	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology		Group - Multi-Specialty
No	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Multi-Specialty
No	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	261QA1903X	Ambulatory Health Care Facilities	Clinic/Center	Ambulatory Surgical	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
	1289020001	Medicare NSC
CA	DM185A	Medicare PIN
	1289020003	Medicare PIN
CO	DM185A	Medicare PIN
CA	1289020001	Medicare NSC
CA	W13687V	Medicare PIN
CA	1289020003	Medicare PIN
CA	W13687F	Medicare PIN
CA	W13687G	Medicare PIN
CA	W13687R	Medicare PIN
CA	W13687S	Medicare PIN
CA	W13687V	Medicare PIN
	1289020003	Medicare PIN
CA	W13687Y	Medicaid
CA	S051198A	Medicare PIN
CA	W13687E	Medicare PIN
CA	W13687Q	Medicare PIN
CA	W13687W	Medicare PIN
CA	W13687	Medicare PIN
CA	W13687D	Medicaid
CA	1289020001	Medicare NSC
CA	W13687A	Medicare PIN
CA	W13687B	Medicare PIN
CA	W13687I	Medicare PIN
CA	W13687Z	Medicaid
CA	W13687K	Medicaid
CA	W13687M	Medicare PIN
CA	W13687N	Medicare PIN
CA	W13687T	Medicare PIN
CA	W13687X	Medicare PIN