Provider Demographics
NPI:1649423856
Name:CARE1ST HEALTH PLAN
Entity Type:Organization
Organization Name:CARE1ST HEALTH PLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-889-6638
Mailing Address - Street 1:601 POTRERO GRANDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-7430
Mailing Address - Country:US
Mailing Address - Phone:323-889-6638
Mailing Address - Fax:
Practice Address - Street 1:601 POTRERO GRANDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-7430
Practice Address - Country:US
Practice Address - Phone:323-889-6638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization