Provider Demographics
NPI:1972723922
Name:CAREMAX SAN DIEGO LLC
Entity Type:Organization
Organization Name:CAREMAX SAN DIEGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LINO
Authorized Official - Middle Name:FRANCO
Authorized Official - Last Name:CARINGAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:714-350-8386
Mailing Address - Street 1:2410 E BALSAM AVENUE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806
Mailing Address - Country:US
Mailing Address - Phone:714-774-8995
Mailing Address - Fax:714-558-7940
Practice Address - Street 1:7915 SILVERTON AVENUE
Practice Address - Street 2:STE 301
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:858-684-3028
Practice Address - Fax:858-684-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies