Provider Demographics
NPI:1689130759
Name:ADVANCED PREMIER PHYSICIANS IPA
Entity Type:Organization
Organization Name:ADVANCED PREMIER PHYSICIANS IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-699-1710
Mailing Address - Street 1:6850 LINCOLN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4179
Mailing Address - Country:US
Mailing Address - Phone:714-699-1710
Mailing Address - Fax:714-699-1712
Practice Address - Street 1:6850 LINCOLN AVE STE 104
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4179
Practice Address - Country:US
Practice Address - Phone:714-699-1710
Practice Address - Fax:714-699-1712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty