Healthcare Provider Details

I. General information

NPI: 1699341644
Provider Name (Legal Business Name): ALERACARE MEDICAL GROUP OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SANTA MONICA BLVD STE 1160W
SANTA MONICA CA
90404-2120
US

IV. Provider business mailing address

7039 VALJEAN AVE STE A
VAN NUYS CA
91406-3915
US

V. Phone/Fax

Practice location:
  • Phone: 888-209-8874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIANNE LABARBERA
Title or Position: PRESIDENT
Credential: MD
Phone: 888-209-8874