Provider Demographics
NPI:1336570464
Name:SCAN HEALTH PLAN (R)
Entity Type:Organization
Organization Name:SCAN HEALTH PLAN (R)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-989-8300
Mailing Address - Street 1:2501 CHERRY AVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2031
Mailing Address - Country:US
Mailing Address - Phone:866-421-1964
Mailing Address - Fax:562-492-6540
Practice Address - Street 1:2501 CHERRY AVE
Practice Address - Street 2:SUITE 380
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2031
Practice Address - Country:US
Practice Address - Phone:866-421-1964
Practice Address - Fax:562-492-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management