Provider Demographics
NPI:1497360077
Name:CARE CONNECTORS MEDICAL GROUP ASSOCIATES
Entity Type:Organization
Organization Name:CARE CONNECTORS MEDICAL GROUP ASSOCIATES
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:KANNARKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-927-0919
Mailing Address - Street 1:4695 MACARTHUR CT STE 1112
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1882
Mailing Address - Country:US
Mailing Address - Phone:310-927-0919
Mailing Address - Fax:
Practice Address - Street 1:7956 CRESCENT MOON PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-1069
Practice Address - Country:US
Practice Address - Phone:310-927-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service