Provider Demographics
NPI:1134855711
Name:BIOFOURMIS CARE CA
Entity type:Organization
Organization Name:BIOFOURMIS CARE CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:845-389-1287
Mailing Address - Street 1:33 ARCH ST FL 17
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1424
Mailing Address - Country:US
Mailing Address - Phone:845-389-1287
Mailing Address - Fax:
Practice Address - Street 1:17875 VON KARMAN AVE STE 150
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6212
Practice Address - Country:US
Practice Address - Phone:855-460-6992
Practice Address - Fax:914-835-8717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty