MEDICARE: HEALTH CARE AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	559712	CA

General Provider Information

NPI Number	:	1083783492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH CARE AGENCY

Provider Business Mailing Address
First Line	:	10662 MCKEEN ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-2456
Country	:	US
Telephone Number	:	714-834-8625
Fax Number	:	714-834-7956

Provider Business Practice Location Address
First Line	:	10662 MCKEEN ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-2456
Country	:	US
Telephone Number	:	714-834-8625
Fax Number	:	714-834-7956

Authorized Official
Title or Position	:	PHN
Name	:	MRS. VIVIAN NGUYEN
Credential	:
Telephone Number	:	714-834-8625

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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