Doctor'S Managed Ipa, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

DOCTOR'S MANAGED IPA, INC

Practice address

1020 S Garfield Ave
Alhambra, CA 91801

Phone

(626) 943-7465

Fax

(626) 458-8051

NPI assigned

Mar 24, 2020

Organization subpart

No

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

Authorized official

Name

Michelle Stewart Black

Title

Administrator

Phone

(626) 943-7465

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1669009247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S GARFIELD AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "91801",
            "telephone_number": "626-943-7465",
            "fax_number": "626-458-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S GARFIELD AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "91801",
            "telephone_number": "626-943-7465",
            "fax_number": "626-458-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR'S MANAGED IPA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-11-12",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-943-7465"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Alhambra, CA
• Providers in Alhambra, 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 Nov 12, 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.