Provider Demographics
NPI:1962044057
Name:ALERACARE MEDICAL GROUP OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ALERACARE MEDICAL GROUP OF CALIFORNIA, A MEDICAL CORPORATION
Other - Org Name:ALERACARE MEDICAL GROUP OF CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LABARBERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-209-8874
Mailing Address - Street 1:7039 VALJEAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3915
Mailing Address - Country:US
Mailing Address - Phone:800-609-3123
Mailing Address - Fax:818-475-1774
Practice Address - Street 1:2331 A MONTPELIER DR
Practice Address - Street 2:STE 20
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1688
Practice Address - Country:US
Practice Address - Phone:888-209-8874
Practice Address - Fax:888-329-4738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty