Provider Demographics
NPI:1114291580
Name:CALIFORNIA CARE CORP.
Entity Type:Organization
Organization Name:CALIFORNIA CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VARDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MNATSAKANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-551-0026
Mailing Address - Street 1:5930 S MAIN ST
Mailing Address - Street 2:STE.104
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1201
Mailing Address - Country:US
Mailing Address - Phone:818-551-0026
Mailing Address - Fax:
Practice Address - Street 1:5930 S MAIN ST
Practice Address - Street 2:STE.104
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1201
Practice Address - Country:US
Practice Address - Phone:818-551-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA CARE CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization