Organization
OPTUMCARE MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
2600 REDONDO AVE, LONG BEACH, CA 90806-2325
(562) 988-7221
Mailing address
600 W 9TH ST, SUITE 1409, LOS ANGELES, CA 90015-4301
(213) 623-7609
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PSY 21006
CA
305R00000X
Preferred Provider Organization
PSY 21006
CA
Other
Enumeration date
09/28/2006
Last updated
09/16/2019
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