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General NPI Number Information
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NPI Number | 1154018067
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Entity Type | Organization
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Legal Business Name | INFUCARE MEDICAL GROUP OF CALIFORNIA INC
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 4240 LATHAM ST STE A
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City | RIVERSIDE
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State | CA
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Zip | 92501-1741
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Country | US
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Telephone | 844-243-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 16782 VON KARMAN AVE STE 12
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City | IRVINE
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State | CA
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Zip | 92606-2417
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GENEVIEVE BENJAMIN
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Credential |
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Telephone | 949-783-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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