Provider Demographics
NPI:1811378987
Name:PLUSHCARE OF CALIFORNIA INC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PLUSHCARE OF CALIFORNIA INC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:WANTUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-231-5333
Mailing Address - Street 1:PO BOX 848299
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-8299
Mailing Address - Country:US
Mailing Address - Phone:415-231-5333
Mailing Address - Fax:415-231-5332
Practice Address - Street 1:101 MISSION ST STE 800
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1744
Practice Address - Country:US
Practice Address - Phone:415-231-5333
Practice Address - Fax:415-231-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty