Californiacarecorp
NPI 1407177785ActiveOrganization· Preferred Provider Organization· Glendale, CA
Preferred Provider Organization in Glendale, California, registered in NPPES in June 2010, part of Californiacarecorp. The authorized official on file is Michael Ming-Ta Su, M.D., Provider.
Overview
| NPI | 1407177785 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Californiacarecorp |
| NPI issued | Jun 21, 2010 |
| Last updated in NPPES | Jun 21, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | A91343 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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