Healthcare Provider Details

I. General information

NPI: 1326198847
Provider Name (Legal Business Name): CARELON HEALTH IPA OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 04/10/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12900 PARK PLAZA DRIVE SUITE 150
CERRITOS CA
90703
US

IV. Provider business mailing address

12900 PARK PLAZA DRIVE SUITE 150
CERRITOS CA
90703
US

V. Phone/Fax

Practice location:
  • Phone: 847-221-4900
  • Fax: 562-467-5400
Mailing address:
  • Phone: 847-221-4900
  • Fax: 562-467-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY C ALBION
Title or Position: CEO
Credential: M.D.
Phone: 847-221-4900