Premiercare Ipa, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

FNP40625 Issued in CA

Legal business name

PREMIERCARE IPA, INC

Practice address

5000 Airport Plaza Dr Ste 150
Long Beach, CA 90815-1275

Phone

(562) 766-2000

Fax

(562) 766-2008

NPI assigned

Sep 29, 2011

Organization subpart

No

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

Authorized official

Name

Michael Wong

Title

Chairman of the Board

Phone

(562) 766-2000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1306120084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AIRPORT PLAZA DR STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151275",
            "telephone_number": "562-766-2000",
            "fax_number": "562-766-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 AIRPORT PLAZA DR STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151275",
            "telephone_number": "562-766-2000",
            "fax_number": "562-766-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERCARE IPA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "562-766-2000"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "FNP40625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desharnae Sharon Pree
• Susana Prego
• Renee Premeaux
• Premier Medical Care, Inc.
• Premier Orthopedic and Spine Group, Inc.
• Premiere Cottages Inc.
• Premise Health of California Medical, P.C
• Rasheed Prescott
• Lawrence Vincent Presley, MD
• Andrew Allen Preston, LMFT

• Health Maintenance Organization in Long Beach, CA
• Providers in Long Beach, 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 Sep 29, 2011; 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.