Provider Demographics
NPI:1770200321
Name:SCAN HEALTH PLAN
Entity type:Organization
Organization Name:SCAN HEALTH PLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-637-7381
Mailing Address - Street 1:21731 N 86TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2495
Mailing Address - Country:US
Mailing Address - Phone:443-677-0576
Mailing Address - Fax:562-285-9494
Practice Address - Street 1:3800 KILROY AIRPORT WAY STE 100
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-6818
Practice Address - Country:US
Practice Address - Phone:855-828-7226
Practice Address - Fax:562-285-9494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCAN HEALTH PLAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251B00000XAgenciesCase Management