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General NPI Number Information
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NPI Number | 1639421589
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Entity Type | Organization
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Legal Business Name | CAREMORE IPA OF NEW YORK, LLC
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 12900 PARK PLAZA DR SUITE 150
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-207-3716
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Fax |
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Provider Business Mailing Address
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Address Line | 12900 PARK PLAZA DR SUITE 150
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-207-3716
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Fax |
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Authorized Official
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Title or Position | MANAGER/PRESIDENT
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Name | MS. LEEBA RUTH LESSIN
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Credential |
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Telephone | 562-622-2813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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