Organization
OPTUMCARE MANAGEMENT, LLC
Active
Parent organization
MEDVANTX, INC.
Other names
HealthCare Partners - Roscoe
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
JOHN G. LEITHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
18433 ROSCOE BLVD, 206, NORTHRIDGE, CA 91325-4108
(818) 341-1540
Mailing address
P.O. BOX 6400, TORRANCE, CA 90504-6400
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G41579
CA
Other
Enumeration date
10/15/2010
Last updated
08/19/2019
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