Healthcare Provider Details
I. General information
NPI: 1497560858
Provider Name (Legal Business Name): CAREQUEST SOLUTIONS NURSING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/11/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
421 N BROOKHURST ST STE 228B
ANAHEIM CA
92801-5619
US
IV. Provider business mailing address
421 N BROOKHURST ST STE 228B
ANAHEIM CA
92801-5619
US
V. Phone/Fax
- Phone: 310-808-3410
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IRIS
BUAN
Title or Position: OWNER
Credential:
Phone: 310-808-3410