Provider Demographics
NPI:1104256841
Name:WORKMED CALIFORNIA, APC
Entity type:Organization
Organization Name:WORKMED CALIFORNIA, APC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-405-1772
Mailing Address - Street 1:14252 CULVER DRIVE, SUITE 809
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:888-405-1772
Mailing Address - Fax:
Practice Address - Street 1:4121 10TH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3109
Practice Address - Country:US
Practice Address - Phone:888-405-1772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2015-02-17
Deactivation Date:2015-01-20
Deactivation Code:
Reactivation Date:2015-02-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty