| Integrated Healthcare Medical Group Inc. | |
|
1762 Westwood Blvd Ste 300 Los Angeles CA 90024-5641 | |
| (310) 441-2000 | |
| (310) 441-2020 |
| Full Name | Integrated Healthcare Medical Group Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1762 Westwood Blvd Ste 300, Los Angeles, California |
| Authorized Official Name and Position | Ifrain Contreras (ADMINISTRATOR) |
| Authorized Official Contact | 3104194303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Healthcare Medical Group Inc. 1762 Westwood Blvd Ste 300 Los Angeles CA 90024-5641 Ph: (310) 441-2000 | Integrated Healthcare Medical Group Inc. 1762 Westwood Blvd Ste 300 Los Angeles CA 90024-5641 Ph: (310) 441-2000 |
| NPI Number | 1801805056 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 7113818766 |
|---|---|
| Medicare Enrollment ID | O20040323000669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801805056 | NPI | - | NPPES |
| GR0085621 | Medicaid | CA | |
| GR0085620 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A38857 (California) | Primary |
| Provider Name | Malek I Sheibani |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417036369 PECOS PAC ID: 3274588934 Enrollment ID: I20050315000801 |
| Provider Name | Parviz Javdan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376640235 PECOS PAC ID: 6204827629 Enrollment ID: I20051024000769 |
| Provider Name | Roya Tabibian |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396890430 PECOS PAC ID: 3779679899 Enrollment ID: I20071019000298 |
| Provider Name | Niloufar Ilani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1962605063 PECOS PAC ID: 8527143072 Enrollment ID: I20080308000129 |
| Provider Name | Karen Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851704977 PECOS PAC ID: 2567773823 Enrollment ID: I20150612002224 |
| Provider Name | Ann Rocelyn Ofelia Datingaling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871026187 PECOS PAC ID: 3577818160 Enrollment ID: I20180622001284 |
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