MEDICARE: TRUCARE TELEHEALTH MEDICAL GROUP

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1942886171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUCARE TELEHEALTH MEDICAL GROUP

Provider Business Mailing Address
First Line	:	20709 GOLDEN SPRINGS DR STE 106
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-3847
Country	:	US
Telephone Number	:	323-596-3530
Fax Number	:	866-473-3822

Provider Business Practice Location Address
First Line	:	20709 GOLDEN SPRINGS DR STE 106
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-3847
Country	:	US
Telephone Number	:	323-596-3530
Fax Number	:	866-473-3822

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SHEMIKA MITCHELL
Credential	:	NURSE PRACTITIONER
Telephone Number	:	323-596-3530

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	09/02/2025

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