Provider Demographics
NPI:1770462293
Name:INTEGRATIVE HEALTHCARE ALLIANCE
Entity type:Organization
Organization Name:INTEGRATIVE HEALTHCARE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PARIS
Authorized Official - Middle Name:EKENE
Authorized Official - Last Name:OBIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-391-0800
Mailing Address - Street 1:7240 SANTA BARBARA CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:323-391-0809
Practice Address - Street 1:3028 E COAST HWY
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2209
Practice Address - Country:US
Practice Address - Phone:323-391-0800
Practice Address - Fax:323-391-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty