Healthcare Provider Details

I. General information

NPI: 1942886171
Provider Name (Legal Business Name): TRUCARE TELEHEALTH MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 09/02/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20709 GOLDEN SPRINGS DR STE 106
WALNUT CA
91789-3847
US

IV. Provider business mailing address

20709 GOLDEN SPRINGS DR STE 106
WALNUT CA
91789-3847
US

V. Phone/Fax

Practice location:
  • Phone: 323-596-3530
  • Fax: 866-473-3822
Mailing address:
  • Phone: 323-596-3530
  • Fax: 866-473-3822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEMIKA MITCHELL
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 323-596-3530