Healthcare Provider Details

I. General information

NPI: 1467609917
Provider Name (Legal Business Name): CALIFORNIA CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N CENTRAL AVE SUITE 106
GLENDALE CA
91203-1403
US

IV. Provider business mailing address

344 E SANTA ANITA AVE G
BURBANK CA
91502-1467
US

V. Phone/Fax

Practice location:
  • Phone: 818-551-0026
  • Fax: 818-551-0027
Mailing address:
  • Phone: 818-563-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: KAREN AYRIYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-551-0026