Provider Demographics
NPI:1548819071
Name:CARE CONNECTORS AFFILIATED PHYSICIANS INC
Entity type:Organization
Organization Name:CARE CONNECTORS AFFILIATED PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:T
Authorized Official - Last Name:KANNARKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-642-5513
Mailing Address - Street 1:PO BOX 15640
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-5640
Mailing Address - Country:US
Mailing Address - Phone:949-642-5513
Mailing Address - Fax:949-642-9479
Practice Address - Street 1:520 SUPERIOR AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
Practice Address - Country:US
Practice Address - Phone:949-642-5513
Practice Address - Fax:949-642-9479
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE CONNECTORS AFFILIATED PHYSICIANS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center