Healthcare Provider Details

I. General information

NPI: 1821988965
Provider Name (Legal Business Name): TITANIUM CARE MANAGEMENT OF NEW YORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12566 VALLEY VIEW ST
GARDEN GROVE CA
92845-2006
US

IV. Provider business mailing address

12566 VALLEY VIEW ST
GARDEN GROVE CA
92845-2006
US

V. Phone/Fax

Practice location:
  • Phone: 562-298-2502
  • Fax: 714-373-4696
Mailing address:
  • Phone: 562-298-2502
  • Fax: 714-373-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: GRAY MILLER
Title or Position: CEO
Credential:
Phone: 832-368-6461