MEDICARE: VISION CORE, INC.

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	251S00000X	Community/Behavioral Health Agency	3524	CA

General Provider Information

NPI Number	:	1245500487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION CORE, INC.

Provider Business Mailing Address
First Line	:	6216 E PACIFIC COAST HWY
Second Line	:	#140
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4867
Country	:	US
Telephone Number	:	866-477-3306
Fax Number	:

Provider Business Practice Location Address
First Line	:	6216 E PACIFIC COAST HWY
Second Line	:	#140
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4867
Country	:	US
Telephone Number	:	866-477-3306
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ROSIA IVEY
Credential	:
Telephone Number	:	866-477-3306

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	06/10/2013

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Directions to “VISION CORE, INC. ” Practice Location

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