| NPI | 1063896942 |
|---|---|
| Doing Business As | FOUNTAIN VALLEY IPA, INC |
| Entity Type | Organization |
| Authorized Contact | VARSHA DESAI Chief Operating Officer 562-602-1563 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |