NPIMap

Organization Active NPI

Primary Care and Pediatric Independent Physicians Association, Inc.

  • Health Maintenance Organization
  • Encino, CA
National Provider Identifier
1649493271
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
G86422 Issued in CA
Legal business name
PRIMARY CARE AND PEDIATRIC INDEPENDENT PHYSICIANS ASSOCIATION, INC.
Practice address
16030 Ventura Blvd Ste 200
Encino, CA 91436-2754
Phone
(818) 461-5030
Fax
(818) 461-5095
NPI assigned
Apr 11, 2007
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Ms. Diane Penn
Title
Compliance Officer
Phone
(818) 461-5030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X G86422 CA Primary

Addresses

Primary practice location

16030 Ventura Blvd Ste 200
Encino, CA 91436-2754

Mailing address

16030 Ventura Blvd Ste 200
Encino, CA 91436-2754
Phone (818) 461-5030

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1649493271",
    "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": "818-461-5030",
            "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": "818-461-5030",
            "fax_number": "818-461-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE AND PEDIATRIC INDEPENDENT PHYSICIANS ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "818-461-5030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "G86422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.