MEDICARE: CORE HEALTHCARE US

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1124698121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HEALTHCARE US

Provider Business Mailing Address
First Line	:	155 N RIVERVIEW DR STE 104
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92808-1225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 N RIVERVIEW DR STE 104
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92808-1225
Country	:	US
Telephone Number	:	310-808-3410
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES VANDEBRAKE
Credential	:
Telephone Number	:	888-354-6993

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	08/09/2021

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Directions to “CORE HEALTHCARE US ” Practice Location

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