Provider Demographics
NPI:1780952523
Name:SOUTHWEST HEALTHCARE MANAGEMENT
Entity type:Organization
Organization Name:SOUTHWEST HEALTHCARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERPRETING COMPANY
Authorized Official - Prefix:MS
Authorized Official - First Name:NASER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANEKI
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:949-609-9244
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92609-1330
Mailing Address - Country:US
Mailing Address - Phone:949-910-6210
Mailing Address - Fax:949-288-6203
Practice Address - Street 1:36 IRON BARK
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2169
Practice Address - Country:US
Practice Address - Phone:949-910-6210
Practice Address - Fax:949-288-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service