Basic Information
| Provider Information | |||||||||
| NPI: | 1215458393 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAREMORE MEDICAL GROUP OF CONNECTICUT, PC | ||||||||
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| OtherOrganizationName: | CAREMORE MEDICAL ASSOCIATES, P.C. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12900 PARK PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907039329 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 444 FOXON RD | ||||||||
| Address2: | |||||||||
| City: | EAST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4752270511 | ||||||||
| FaxNumber: | 4752386372 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2017 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | KWAN | ||||||||
| AuthorizedOfficialFirstName: | ALI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5134532650 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CAREMORE MEDICAL ASSOCIATES, P.C. | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.