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General NPI Number Information
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NPI Number | 1326198847
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Entity Type | Organization
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Legal Business Name | CARELON HEALTH IPA OF CALIFORNIA
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 12900 PARK PLAZA DRIVE SUITE 150
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 847-221-4900
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Fax | 562-467-5400
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Provider Business Mailing Address
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Address Line | 12900 PARK PLAZA DRIVE SUITE 150
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 847-221-4900
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Fax | 562-467-5400
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY C ALBION
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Credential | M.D.
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Telephone | 847-221-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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