Provider Demographics
NPI:1598910549
Name:ARCADIAN HEALTH PLAN, INC.
Entity Type:Organization
Organization Name:ARCADIAN HEALTH PLAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP AND GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:510-817-1845
Mailing Address - Street 1:500 12TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-5204
Mailing Address - Country:US
Mailing Address - Phone:510-832-0311
Mailing Address - Fax:510-817-1894
Practice Address - Street 1:500 12TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4087
Practice Address - Country:US
Practice Address - Phone:510-832-0311
Practice Address - Fax:510-817-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12151302R00000X
ME112421302R00000X
SC166975302R00000X
TX13794 (FOR AHP)302R00000X
WA174302R00000X
CAFILE NUMBER 933 0468302R00000X
MO12151302R00000X
NH103078302R00000X
VA12151302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH103078OtherMEDICARE ADVANTAGE
SC166975OtherMEDICARE ADVANTAGE
CAFILE NUMBER 933 0468OtherMEDICARE ADVANTAGE
MO12151OtherMEDICARE ADVANTAGE
VA12151OtherMEDICARE ADVANTAGE
AZ12151OtherMEDICARE ADVANTAGE
TX13794 (FOR AHP)OtherMEDICARE ADVANTAGE
ME112421OtherMEDICARE ADVANTAGE
WA174OtherMEDICARE ADVANTAGE