MEDICARE: NOVA CARE CLINIC, 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1205786621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA CARE CLINIC, INC

Provider Business Mailing Address
First Line	:	2944 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3726
Country	:	US
Telephone Number	:	562-599-5777
Fax Number	:	714-844-4520

Provider Business Practice Location Address
First Line	:	2944 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3726
Country	:	US
Telephone Number	:	562-599-5777
Fax Number	:	714-844-4520

Authorized Official
Title or Position	:	OPERATION MANAGER
Name	:	KATIE TRAN
Credential	:
Telephone Number	:	562-599-5777

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “NOVA CARE CLINIC, INC ” Practice Location

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