Provider Demographics
NPI:1487029278
Name:WORKMED CALIFORNIA A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:WORKMED CALIFORNIA A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:866-980-9580
Mailing Address - Street 1:14252 CULVER DR
Mailing Address - Street 2:SUITE NUMBER 809
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0317
Mailing Address - Country:US
Mailing Address - Phone:866-980-9580
Mailing Address - Fax:
Practice Address - Street 1:5321 N FRESNO ST
Practice Address - Street 2:SUITE NUMBER 105C
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6850
Practice Address - Country:US
Practice Address - Phone:559-224-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-06
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA193400000X208D00000X
CA207P00000X208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty