Provider Demographics
NPI:1295237246
Name:AFFILIATED PARTNERS IPA
Entity type:Organization
Organization Name:AFFILIATED PARTNERS IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:TUAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-591-3222
Mailing Address - Street 1:1210 N JEFFERSON ST
Mailing Address - Street 2:UNIT D
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 E PACIFIC COAST HWY
Practice Address - Street 2:STE 102
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5579
Practice Address - Country:US
Practice Address - Phone:562-287-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization