Healthcare Provider Details

I. General information

NPI: 1558408369
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17722 SANTIAGO CANYON RD
SILVERADO CA
92676-9764
US

IV. Provider business mailing address

163 TECHNOLOGY DR STE 200
IRVINE CA
92618-2486
US

V. Phone/Fax

Practice location:
  • Phone: 714-649-0533
  • Fax: 714-649-3543
Mailing address:
  • Phone: 949-794-0787
  • Fax: 949-266-8679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060000521
License Number StateCA

VIII. Authorized Official

Name: SEAN SHEA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 617-688-5251