NPIMap

Organization Active NPI

Optumcare Management, LLC

  • Health Maintenance Organization
  • Los Angeles, CA
National Provider Identifier
1316966542
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
A62946 Issued in CA
Legal business name
OPTUMCARE MANAGEMENT, LLC
Practice address
11706 Darlington Ave
Apt 202
Los Angeles, CA 90049-5517
Phone
(310) 613-5566
Fax
(310) 442-6633
NPI assigned
Jul 19, 2006
Last updated
Aug 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John G. Liethen
Title
Secretary
Phone
(952) 205-6262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X A62946 CA Primary

Addresses

Primary practice location

11706 Darlington Ave
Apt 202
Los Angeles, CA 90049-5517

Mailing address

P.O. Box 6400
Torrance, CA 90504-6400
Phone (310) 613-5566

National Provider Directory

National Provider Directory
Tax ID family
Optumcare Management LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1316966542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6400",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905046400",
            "telephone_number": "310-613-5566",
            "fax_number": "310-442-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11706 DARLINGTON AVE",
            "address_2": "APT 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495517",
            "telephone_number": "310-613-5566",
            "fax_number": "310-442-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "LIETHEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "952-205-6262"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "A62946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.