MEDICARE: ALERACARE MEDICAL GROUP OF CALIFORNIA, A MEDICAL CORPORATION

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1114636578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALERACARE MEDICAL GROUP OF CALIFORNIA, A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	7039 VALJEAN AVE STE A
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-3915
Country	:	US
Telephone Number	:	888-209-8874
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 ARDEN AVE STE 460
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1139
Country	:	US
Telephone Number	:	888-209-8874
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIANNE LABARBERA
Credential	:	MD
Telephone Number	:	888-209-8874

Provider Enumeration Date	:	11/15/2022
Last Update Date	:	09/20/2024

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