MEDICARE: AFFINITY CARE GROUP LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1609342427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY CARE GROUP LLC

Provider Business Mailing Address
First Line	:	1926 PARK ST STE 3
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1420
Country	:	US
Telephone Number	:	888-816-2813
Fax Number	:	628-888-0686

Provider Business Practice Location Address
First Line	:	1926 PARK ST STE 3
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1420
Country	:	US
Telephone Number	:	888-816-2813
Fax Number	:	628-888-0686

Authorized Official
Title or Position	:	CEO
Name	:	DAVID LINGAN
Credential	:
Telephone Number	:	510-388-0073

Provider Enumeration Date	:	10/18/2018
Last Update Date	:	11/23/2021

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