1356511307 NPI number — CARE DIMENSIONS LLC

Table of content: (NPI 1356511307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356511307 NPI number — CARE DIMENSIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE DIMENSIONS LLC
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:
CARE DIMENSIONS
Provider Other Organization Name Type Code:
5
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:
1356511307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3401 W SUNFLOWER AVE.
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92704-6948
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-619-8766
Provider Business Mailing Address Fax Number:
714-619-8769

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2025 N GLENOAKS BLVD.
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
BURBANK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91504-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-319-3477
Provider Business Practice Location Address Fax Number:
818-736-9100
Provider Enumeration Date:
03/05/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PHAN
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER OF THE LLC
Authorized Official Telephone Number:
714-619-8766

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  550000329 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 550000329 . This is a "DEPARTMENT OF PUBLIC HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".