1780955310 NPI number — CAL MEDICAL SERVICES, INC.

Table of content: (NPI 1780955310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780955310 NPI number — CAL MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAL MEDICAL SERVICES, INC.
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:
6
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:
1780955310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 W FOOTHILL PKWY
Provider Second Line Business Mailing Address:
#105 PMB 198
Provider Business Mailing Address City Name:
CORONA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92882-8545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-208-5655
Provider Business Mailing Address Fax Number:
800-308-2710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1485 SPRUCE ST
Provider Second Line Business Practice Location Address:
SUITE Q
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92507-2445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-279-8799
Provider Business Practice Location Address Fax Number:
800-308-2710
Provider Enumeration Date:
01/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
AMIN
Authorized Official First Name:
CHIRAG
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
909-208-5655

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  A72688 , 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)





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