Provider Demographics
NPI:1437528643
Name:FIRST CARE MEDICAL CORP
Entity Type:Organization
Organization Name:FIRST CARE MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUYNAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:657-245-3345
Mailing Address - Street 1:3760 W MCFADDEN AVE
Mailing Address - Street 2:UNIT B-145
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1392
Mailing Address - Country:US
Mailing Address - Phone:657-245-3345
Mailing Address - Fax:657-202-2001
Practice Address - Street 1:4702 W 1ST ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3100
Practice Address - Country:US
Practice Address - Phone:657-245-3345
Practice Address - Fax:657-202-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty