Healthcare Provider Details

I. General information

NPI: 1184901746
Provider Name (Legal Business Name): CHINESE COMMUNITY HEALTH PLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 12/21/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 GRANT AVE SUITE 700
SAN FRANCISCO CA
94108-3249
US

IV. Provider business mailing address

445 GRANT AVE SUITE 700
SAN FRANCISCO CA
94108-3249
US

V. Phone/Fax

Practice location:
  • Phone: 415-955-8800
  • Fax: 415-955-8818
Mailing address:
  • Phone: 415-955-8800
  • Fax: 415-955-8818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number933-0278
License Number StateCA

VIII. Authorized Official

Name: MR. LAWRENCE LOO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.P.H
Phone: 415-995-8832