Healthcare Provider Details

I. General information

NPI: 1659260958
Provider Name (Legal Business Name): OCTACARE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 W FOOTHILL BLVD STE 158
UPLAND CA
91786-3768
US

IV. Provider business mailing address

1126 W FOOTHILL BLVD STE 158
UPLAND CA
91786-3768
US

V. Phone/Fax

Practice location:
  • Phone: 866-883-6282
  • Fax:
Mailing address:
  • Phone: 866-883-6282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: GIDOMER E FRANCIA
Title or Position: CEO
Credential:
Phone: 866-883-6282