Provider Demographics
NPI:1780860866
Name:HEALTH NET LIFE INSURANCE COMPANY, CA PPO
Entity Type:Organization
Organization Name:HEALTH NET LIFE INSURANCE COMPANY, CA PPO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT HEALTH NET LIFE INSURANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-676-8454
Mailing Address - Street 1:21650 OXNARD ST
Mailing Address - Street 2:MAIL STOP: CA-102-22-12
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4901
Mailing Address - Country:US
Mailing Address - Phone:818-676-8767
Mailing Address - Fax:818-676-7754
Practice Address - Street 1:21281 BURBANK BLVD
Practice Address - Street 2:MAIL STOP: CA-900-03-31
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6607
Practice Address - Country:US
Practice Address - Phone:818-676-8767
Practice Address - Fax:818-676-7754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH NET, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization