Healthcare Provider Details

I. General information

NPI: 1144326166
Provider Name (Legal Business Name): CARE MEDICAL OFFICE A CALIFORNIA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 PASSONS BLVD STE A
PICO RIVERA CA
90660-3632
US

IV. Provider business mailing address

6766 PASSONS BLVD STE A
PICO RIVERA CA
90660-3632
US

V. Phone/Fax

Practice location:
  • Phone: 562-949-7979
  • Fax:
Mailing address:
  • Phone: 562-949-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberA46188
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierGR0069610
Identifier TypeMEDICAID
Identifier StateCA
Identifier Issuer

VIII. Authorized Official

Name: DR. ROBERTO LUARCA
Title or Position: OWNER
Credential: M.D.
Phone: 562-949-7979