Provider Demographics
NPI:1770592024
Name:CAL-CARE MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:CAL-CARE MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REFAAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-427-1700
Mailing Address - Street 1:500 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2831
Mailing Address - Country:US
Mailing Address - Phone:562-427-1700
Mailing Address - Fax:562-427-2116
Practice Address - Street 1:500 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2831
Practice Address - Country:US
Practice Address - Phone:562-427-1700
Practice Address - Fax:562-427-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35232261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0078150Medicaid
CAGR0078150Medicaid
CAA84748Medicare ID - Type Unspecified