| Organization Name: | HERITAGE PROVIDER NETWORK, INC. |
| NPI Number: | 1881720001 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLA COURTNEY (DIRECTOR OF FFS) |
| Mailing Address: | 8510 Balboa Blvd Suite 275 Northridge |
| State: | CA US |
| Postal Code: | 913253583 |
| Phone Number: | 8186543400 |
| Fax Number: | 8186543460 |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 09/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |