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General NPI Number Information
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NPI Number | 1528351376
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Entity Type | Organization
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Legal Business Name | PROACTIVE CARE PROFESSIONALS, INC. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 180 N OAKLAND AVE
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City | PASADENA
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State | CA
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Zip | 91101-1714
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Country | US
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Telephone | 626-355-8595
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Fax | 626-355-8591
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Provider Business Mailing Address
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Address Line | 80 W SIERRA MADRE BLVD # 397
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2434
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Country | US
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Telephone | 626-355-8595
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Fax | 626-355-8591
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Authorized Official
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Title or Position | CEO
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Name | WARREN BROWN
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Credential |
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Telephone | 626-355-8595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A70884
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A70884
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License Number State | CA
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