Provider Demographics
NPI:1174808802
Name:PARTNERS IN MEDICINE
Entity type:Organization
Organization Name:PARTNERS IN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/NETWORK STRATEGY
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-788-3577
Mailing Address - Street 1:100 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4359
Mailing Address - Country:US
Mailing Address - Phone:310-320-3990
Mailing Address - Fax:
Practice Address - Street 1:481 PLUMAS BLVD
Practice Address - Street 2:#104
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5075
Practice Address - Country:US
Practice Address - Phone:530-671-2883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty