Provider Demographics
NPI:1750738662
Name:IMPERIAL HEALTH PLAN OF CALIFORNIA, INC
Entity type:Organization
Organization Name:IMPERIAL HEALTH PLAN OF CALIFORNIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAVELJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BINDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-755-8831
Mailing Address - Street 1:600 S LAKE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3955
Mailing Address - Country:US
Mailing Address - Phone:626-243-2276
Mailing Address - Fax:626-521-6028
Practice Address - Street 1:600 S LAKE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3955
Practice Address - Country:US
Practice Address - Phone:626-243-2276
Practice Address - Fax:626-521-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20152265302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization