Provider Demographics
NPI:1003067877
Name:APPLECARE MEDICAL GROUP
Entity Type:Organization
Organization Name:APPLECARE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:
Authorized Official - Last Name:JIVRAJKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-443-4500
Mailing Address - Street 1:6131 ORANGETHORPE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-1315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6131 ORANGETHORPE AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-1315
Practice Address - Country:US
Practice Address - Phone:714-443-4512
Practice Address - Fax:714-443-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty