NPIMap

Organization Active NPI

Optumcare Management, LLC

  • Non-Pharmacy Dispensing Site
  • Long Beach, CA
National Provider Identifier
1881908887
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
12879 Issued in CA
Legal business name
OPTUMCARE MANAGEMENT, LLC
Practice address
4401 Atlantic Ave
3Rd
Long Beach, CA 90807-2218
Phone
(562) 481-3500
NPI assigned
Aug 2, 2010
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

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
Non-Pharmacy Dispensing Site 332900000X 12879 CA Primary

Addresses

Primary practice location

4401 Atlantic Ave
3Rd
Long Beach, CA 90807-2218

Mailing address

P.O. Box 6400
Torrance, CA 90504-6400

Other names 1

  • HEALTHCARE PARTNERS - SAN ANTONIO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optumcare Management LLC11 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 10

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

Locations

4401 Atlantic Ave
Long Beach, CA 90807
Phone (562) 428-3266

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1881908887",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVE",
            "address_2": "3RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072218",
            "telephone_number": "562-481-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE MANAGEMENT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2010-08-02",
        "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": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "12879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHCARE PARTNERS - SAN ANTONIO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEALTHCARE PARTNERS - SAN ANTONIO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, 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.