Healthcare Provider Details

I. General information

NPI: 1235404674
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5640 AZTEC DR
LA MESA CA
91942-1948
US

IV. Provider business mailing address

163 TECHNOLOGY DR STE 200
IRVINE CA
92618-2486
US

V. Phone/Fax

Practice location:
  • Phone: 949-263-6632
  • Fax: 949-261-0457
Mailing address:
  • Phone: 949-794-0787
  • Fax: 949-261-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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