Healthcare Provider Details

I. General information

NPI: 1962331900
Provider Name (Legal Business Name): CARE CONNECTORS MEDICAL GROUP HUM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4695 MACARTHUR CT # 1112A
NEWPORT BEACH CA
92660-1882
US

IV. Provider business mailing address

4695 MACARTHUR CT # 1112A
NEWPORT BEACH CA
92660-1882
US

V. Phone/Fax

Practice location:
  • Phone: 310-927-0919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINOD KANNARKAT
Title or Position: AUTHORIZED PERSON
Credential: MD
Phone: 310-927-0919