Healthcare Provider Details

I. General information

NPI: 1033436878
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12461 SPRINGDALE ST
GARDEN GROVE CA
92845-2240
US

IV. Provider business mailing address

163 TECHNOLOGY DR STE 200
IRVINE CA
92618-2486
US

V. Phone/Fax

Practice location:
  • Phone: 714-933-7560
  • Fax: 714-933-7565
Mailing address:
  • Phone: 949-263-6632
  • Fax: 949-261-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number550001247
License Number StateCA

VIII. Authorized Official

Name: SEAN SHEA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 617-688-5251