Provider Demographics
NPI:1629175856
Name:FIRST CARE MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:FIRST CARE MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CORPUS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:530-865-4400
Mailing Address - Street 1:750 E WALKER ST STE A
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95963-2222
Mailing Address - Country:US
Mailing Address - Phone:530-865-4400
Mailing Address - Fax:530-865-7285
Practice Address - Street 1:750 E WALKER ST STE A
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:CA
Practice Address - Zip Code:95963-2222
Practice Address - Country:US
Practice Address - Phone:530-865-4400
Practice Address - Fax:530-865-7285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM08922FMedicaid
CARHM08922FMedicaid
CA058922Medicare Oscar/Certification