Provider Demographics
NPI:1013456672
Name:TRUCARE MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TRUCARE MEDICAL CORPORATION
Other - Org Name:TRUCARE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYRIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-547-2006
Mailing Address - Street 1:5100 E LA PALMA AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2081
Mailing Address - Country:US
Mailing Address - Phone:714-883-1604
Mailing Address - Fax:
Practice Address - Street 1:1234 W CHAPMAN AVE
Practice Address - Street 2:STE# 101
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2862
Practice Address - Country:US
Practice Address - Phone:714-883-1604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34641207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty