MEDICARE: GREAT CARE PROVIDERS 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	207Q00000X	Family Medicine Physician	G46052	CA

General Provider Information

NPI Number	:	1942434949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT CARE PROVIDERS INC

Provider Business Mailing Address
First Line	:	23890 COPPER HILL DR
Second Line	:	SUITE 515
City	:	VALENCIA
State	:	CA
Zip	:	91354-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23890 COPPER HILL DR
Second Line	:	SUITE 515
City	:	VALENCIA
State	:	CA
Zip	:	91354-1701
Country	:	US
Telephone Number	:	818-288-8933
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GEOFFREY L LOMAN
Credential	:	MD
Telephone Number	:	818-288-8933

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	09/15/2009

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Directions to “GREAT CARE PROVIDERS INC ” Practice Location

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