Provider Demographics
NPI:1730668526
Name:WELL CARE MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:WELL CARE MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMANIOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-654-7990
Mailing Address - Street 1:8549 WILSHIRE BLVD STE 1149
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3104
Mailing Address - Country:US
Mailing Address - Phone:714-654-7990
Mailing Address - Fax:
Practice Address - Street 1:8780 VAN NUYS BLVD STE B
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-2454
Practice Address - Country:US
Practice Address - Phone:818-894-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72796174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty