OrganizationActive
Californiacarecorp
NPI 1407177785 · Preferred Provider Organization · Glendale, CA
Provider details
- NPI number
- 1407177785
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Parent organization
- Californiacarecorp
- Organization subpart
- Yes
- Authorized official
- Michael Su, Provider(818) 551-0026
- License
- A91343 (CA)
Specialties & taxonomies
Managed Care Organizations
Practice location
127 S Brand Blvd # 241
Glendale, CA 91204-1342
Phone: (818) 551-0026
Approximate (ZIP-level) locationGet directions
Mailing address
127 S Brand Blvd # 241
Glendale, CA 91204-1342
Registry dates
- Enumerated
- 2010-06-21
- Last updated
- 2010-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.