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NPI Code Detail

MEDICARE: PREMIER CARE CENTER

MEDICARE: PREMIER CARE CENTER
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
1261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1548633100
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER CARE CENTER
Provider Business Mailing Address
First Line : PO BOX 31001-2130
Second Line :
City : PASADENA
State : CA
Zip : 91110-2130
Country : US
Telephone Number : 213-412-1973
Fax Number : 213-412-1981
Provider Business Practice Location Address
First Line : 2990 E RAMON RD
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-7931
Country : US
Telephone Number : 951-689-5788
Fax Number : 951-689-9231
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DR. JOHN HEYDT
Credential : M.D.
Telephone Number : 714-456-2986
Provider Enumeration Date : 11/04/2015
Last Update Date : 11/04/2015

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Directions to “PREMIER CARE CENTER ” Practice Location

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