Basic Information
| Provider Information | |||||||||
| NPI: | 1215295753 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAREMORE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12900 PARK PLAZA DRIVE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627414470 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1182 N. EUCLID ST. | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143999222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2012 | ||||||||
| LastUpdateDate: | 05/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | CASILANG | ||||||||
| AuthorizedOfficialFirstName: | REGINALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7143999222 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | 20658 | CA | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.