Healthcare Provider Details

I. General information

NPI: 1497615330
Provider Name (Legal Business Name): CARE CREW MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 S BROOKHURST ST STE 4
ANAHEIM CA
92804-2448
US

IV. Provider business mailing address

512 S BROOKHURST ST STE 4
ANAHEIM CA
92804-2448
US

V. Phone/Fax

Practice location:
  • Phone: 507-517-5808
  • Fax:
Mailing address:
  • Phone: 507-517-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANAS ANWAR AL THAHABI
Title or Position: OWNER
Credential:
Phone: 507-517-5808