Provider Demographics
NPI:1427315621
Name:COMMISSION ON MEDICAL CARE
Entity type:Organization
Organization Name:COMMISSION ON MEDICAL CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGREN
Authorized Official - Suffix:
Authorized Official - Credentials:CHC
Authorized Official - Phone:707-419-7914
Mailing Address - Street 1:4665 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1675
Mailing Address - Country:US
Mailing Address - Phone:800-863-4155
Mailing Address - Fax:707-863-4117
Practice Address - Street 1:4665 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1675
Practice Address - Country:US
Practice Address - Phone:800-863-4155
Practice Address - Fax:707-863-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization