Provider Demographics
NPI:1649608167
Name:MULTICARE HEALTH CENTER
Entity type:Organization
Organization Name:MULTICARE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-252-1985
Mailing Address - Street 1:2010 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 809
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3507
Mailing Address - Country:US
Mailing Address - Phone:213-252-1985
Mailing Address - Fax:213-252-1986
Practice Address - Street 1:2010 WILSHIRE BLVD
Practice Address - Street 2:SUITE 809
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3507
Practice Address - Country:US
Practice Address - Phone:213-252-1985
Practice Address - Fax:213-252-1986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27942111N00000X
CAA76500207LP2900X
CABR784451207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty