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General NPI Number Information
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NPI Number | 1497360077
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Entity Type | Organization
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Legal Business Name | CARE CONNECTORS MEDICAL GROUP ASSOCIATES
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 7956 CRESCENT MOON PL
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City | EL PASO
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State | TX
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Zip | 79932-1069
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Country | US
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Telephone | 310-927-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 4695 MACARTHUR CT STE 1112
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1882
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Country | US
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Telephone | 310-927-0919
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINOD KANNARKAT
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Credential | MD
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Telephone | 310-927-0919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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