Healthcare Provider Details
I. General information
NPI: 1689298317
Provider Name (Legal Business Name): CAREPLUS MEDICAL CLINIC A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2020
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5783 E LA PALMA AVE
ANAHEIM CA
92807-2229
US
IV. Provider business mailing address
5783 E LA PALMA AVE
ANAHEIM CA
92807-2229
US
V. Phone/Fax
- Phone: 714-777-1285
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FIROUZEH
FAYE
SABERI
Title or Position: OWNER, FAMILY NP
Credential: NP
Phone: 714-777-1285