1770656829 NPI number — CAREMORE MEDICAL GROUP

Table of content: (NPI 1770656829)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770656829 NPI number — CAREMORE MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREMORE MEDICAL GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770656829
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 51238
Provider Second Line Business Mailing Address:
ATTENTION MAGGIE NOLES
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90051-5538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-741-4461
Provider Business Mailing Address Fax Number:
562-741-4401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12900 PARK PLAZA DR
Provider Second Line Business Practice Location Address:
# 150 ATTN MAGGIE NOLES
Provider Business Practice Location Address City Name:
CERRITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90703-8564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-741-4461
Provider Business Practice Location Address Fax Number:
562-741-4401
Provider Enumeration Date:
11/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZINBERG
Authorized Official First Name:
SHELDON
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
562-741-4461

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)