Healthcare Provider Details

I. General information

NPI: 1366231680
Provider Name (Legal Business Name): CALIFORNIA ECM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2281 LAVA RIDGE CT STE 200
ROSEVILLE CA
95661-2805
US

IV. Provider business mailing address

2281 LAVA RIDGE CT STE 200
ROSEVILLE CA
95661-2805
US

V. Phone/Fax

Practice location:
  • Phone: 415-535-6179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: IGOR DOBREV
Title or Position: PRESIDENT
Credential:
Phone: 415-535-6179