| Organization Name: | MEMORIAL HEALTHCARE IPA GP C/O INDEPENDENT PHYSICIAN MGNT SERVIC |
| NPI Number: | 1770772824 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KURT M TAMARU (PRESIDENT) |
| Mailing Address: | 2704 E Willow St Signal Hill |
| State: | CA US |
| Postal Code: | 907552217 |
| Phone Number: | 5625950203 |
| Fax Number: | 5625950062 |
| NPI Enumeration Date: | 10/15/2007 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |