MEDICARE: PRIMECARE PLUS, INC.

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	251E00000X	Home Health Agency	PENDIING	CA

General Provider Information

NPI Number	:	1194978437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMECARE PLUS, INC.

Provider Business Mailing Address
First Line	:	2372 MORSE AVE
Second Line	:	SUITE 6
City	:	IRVINE
State	:	CA
Zip	:	92614-6234
Country	:	US
Telephone Number	:	949-681-3515
Fax Number	:

Provider Business Practice Location Address
First Line	:	2372 MORSE AVE
Second Line	:	SUITE 6
City	:	IRVINE
State	:	CA
Zip	:	92614-6234
Country	:	US
Telephone Number	:	949-681-3515
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. LI H CUTLER
Credential	:
Telephone Number	:	949-681-3515

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	10/30/2008

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