Organization
RAV PREMERA CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN MEJIA (MANAGING MEMBER)
(949) 394-8708
Entity
Organization
Contact information
Practice address
864 N FORD AVE, FULLERTON, CA 92832-1261
(949) 394-8708
Mailing address
864 N FORD AVE, FULLERTON, CA 92832-1261
(949) 394-8708
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306005851
CCLD RCFE
CA
Enumeration date
03/30/2021
Last updated
06/10/2025
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