Provider Demographics
NPI:1174360606
Name:MD PARTNERS IPA
Entity type:Organization
Organization Name:MD PARTNERS IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTCEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KULDIP
Authorized Official - Middle Name:S
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-263-5349
Mailing Address - Street 1:280 SIERRA COLLEGE DR
Mailing Address - Street 2:STE #205
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5726
Mailing Address - Country:US
Mailing Address - Phone:657-217-4500
Mailing Address - Fax:657-206-3375
Practice Address - Street 1:280 SIERRA COLLEGE DR
Practice Address - Street 2:STE #205
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5726
Practice Address - Country:US
Practice Address - Phone:657-217-4500
Practice Address - Fax:657-206-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization