Premier Physician Network

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

G040404 Issued in CA

Legal business name

PREMIER PHYSICIAN NETWORK

Practice address

16030 Ventura Blvd Ste 200
Encino, CA 91436-2754

Phone

(818) 541-5030

Fax

(818) 461-5095

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Irving Sobel, MD

Title

Owner

Phone

(818) 461-5030

Specialties & licenses 1

Addresses

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275655250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16030 VENTURA BLVD STE 200",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362754",
            "telephone_number": "818-541-5030",
            "fax_number": "818-461-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16030 VENTURA BLVD STE 200",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362754",
            "telephone_number": "818-541-5030",
            "fax_number": "818-461-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIAN NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOBEL",
        "authorized_official_first_name": "IRVING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-461-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "G040404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John-Paul Agustin Prakash, BCBA
• Paravee Prakongsup
• Natalie Celeste Preciado
• Preferred Home Health Care Inc.
• Premier Digestive Health a Medical Corporation
• Premium Podiatry, Inc.
• Imani Pressley, MA, APCC
• Thomas Edgar Preston, MD
• Irvin Pretsky, MD
• Paul Prettapapop

• Health Maintenance Organization in Encino, CA
• Providers in Encino, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.