Healthcare Provider Details

I. General information

NPI: 1770620569
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E AVOCADO CREST RD
LA HABRA HEIGHTS CA
90631-8122
US

IV. Provider business mailing address

163 TECHNOLOGY DR STE 200
IRVINE CA
92618-2486
US

V. Phone/Fax

Practice location:
  • Phone: 562-691-2486
  • Fax: 562-691-9505
Mailing address:
  • Phone: 949-263-6632
  • Fax: 949-266-8679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number980000693
License Number StateCA

VIII. Authorized Official

Name: MR. SEAN SHEA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 949-794-0787