Healthcare Provider Details

I. General information

NPI: 1497191399
Provider Name (Legal Business Name): CALIFORNIA HEALTH AND WELLNESS PLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 CREEKSIDE OAKS DR
SACRAMENTO CA
95833-3639
US

IV. Provider business mailing address

1740 CREEKSIDE OAKS DR
SACRAMENTO CA
95833-3639
US

V. Phone/Fax

Practice location:
  • Phone: 877-658-0305
  • Fax:
Mailing address:
  • Phone: 877-658-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BOWERS
Title or Position: PRESIDENT
Credential:
Phone: 877-658-0305