Icare-USA LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

201618710208 Issued in CA

Legal business name

ICARE-USA LLC

Practice address

11036 Caminito Alvarez
San Diego, CA 92126-5701

Phone

(619) 547-9394

NPI assigned

Sep 25, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Aneceto Alcantara Mendoza

Title

President/Ceo

Phone

(619) 547-9394

Specialties & licenses 1

Addresses

Other names 1

• ICARE-USA LLC Former legal business name

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474761600000",
    "number": "1477002079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11036 CAMINITO ALVAREZ",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921265701",
            "telephone_number": "619-547-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11036 CAMINITO ALVAREZ",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921265701",
            "telephone_number": "619-547-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE-USA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-25",
        "last_updated": "2016-09-25",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ANECETO",
        "authorized_official_middle_name": "ALCANTARA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "619-547-9394",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "201618710208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICARE-USA LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Devika Icecreamwala, MD

• Point of Service in San Diego, CA
• Providers in San Diego, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2016; 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.