Healthcare Provider Details

I. General information

NPI: 1508614595
Provider Name (Legal Business Name): INCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 07/13/2024
Certification Date: 07/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CRESCENT DR
BEVERLY HILLS CA
90210-4860
US

IV. Provider business mailing address

5008 PICKFORD WAY
CULVER CITY CA
90230-4916
US

V. Phone/Fax

Practice location:
  • Phone: 213-262-8787
  • Fax:
Mailing address:
  • Phone: 413-626-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ZACHARY ROLLINS BARNARD
Title or Position: PRESIDENT
Credential: MD
Phone: 413-626-1819