Provider Demographics
NPI:1912661174
Name:PRIMECARE GLOBAL SERVICES CORP
Entity type:Organization
Organization Name:PRIMECARE GLOBAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ASHU
Authorized Official - Last Name:TAKANG
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:714-863-9560
Mailing Address - Street 1:5493 STONEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8933
Mailing Address - Country:US
Mailing Address - Phone:714-863-9560
Mailing Address - Fax:
Practice Address - Street 1:5493 STONEVIEW RD
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-8933
Practice Address - Country:US
Practice Address - Phone:714-863-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No273R00000XHospital UnitsPsychiatric Unit