Healthcare Provider Details

I. General information

NPI: 1629817275
Provider Name (Legal Business Name): CAL COORDINATORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 IRWIN ST STE 303
SAN RAFAEL CA
94901-3343
US

IV. Provider business mailing address

851 IRWIN ST STE 303
SAN RAFAEL CA
94901-3343
US

V. Phone/Fax

Practice location:
  • Phone: 818-810-7050
  • Fax:
Mailing address:
  • Phone: 818-810-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LEVON MANUKYAN
Title or Position: CEO
Credential:
Phone: 818-918-9190