Pacific Crest Healthcare Independent Provider Association, Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PACIFIC CREST HEALTHCARE INDEPENDENT PROVIDER ASSOCIATION, INC.

Practice address

2601 Airport Dr Ste 250
Torrance, CA 90505-6141

Phone

(833) 724-4111

NPI assigned

Nov 18, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rod Amiri, MD

Title

Administrator

Phone

(833) 724-4111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Crest Healthcare IPA Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1043977655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 AIRPORT DR STE 250",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056141",
            "telephone_number": "833-724-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 AIRPORT DR STE 250",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056141",
            "telephone_number": "833-724-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CREST HEALTHCARE INDEPENDENT PROVIDER ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "833-724-4111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA SECRETARY OF STATE CORPORATION",
            "identifier": "C4080636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Crest Healthcare IPA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific Crest Healthcare IPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Exclusive Provider Organization in Torrance, CA
• Providers in Torrance, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.