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General NPI Number Information
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NPI Number | 1982900346
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Entity Type | Organization
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Legal Business Name | CALIFORNIA CARE CORP
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 02/02/2011
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Provider Practice Location Address
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Address Line | 610 N CENTRAL AVE STE 106
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City | GLENDALE
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State | CA
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Zip | 91203-1418
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Country | US
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Telephone | 818-551-0026
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Fax | 818-551-0027
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Provider Business Mailing Address
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Address Line | 610 N CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91203-1403
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Country | US
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Telephone | 818-551-0026
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Fax | 818-551-0027
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Authorized Official
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Title or Position | COUNSELOR
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Name | RUTH A MASTERSON
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Credential |
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Telephone | 818-551-0026
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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 | 197331
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License Number State | CA
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