Provider Demographics
NPI:1184100471
Name:CARE ALLIES IPA, INC
Entity type:Organization
Organization Name:CARE ALLIES IPA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PCP
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-999-1050
Mailing Address - Street 1:3321 HOLLYPARK DR APT 2
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-4699
Mailing Address - Country:US
Mailing Address - Phone:323-394-5368
Mailing Address - Fax:
Practice Address - Street 1:1211 W LA PALMA AVE STE 309
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2811
Practice Address - Country:US
Practice Address - Phone:714-999-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization