Provider Information Updates
PHC California is dedicated to maintaining accurate and up-to-date provider information. Updating your information is easy! Simply complete the online Provider Information form with all current information at the link below. Any changes to billing/remit addresses will also require a new W-9 to be submitted. Please submit W-9 documents to our PDM team at [email protected].
All of the provider information update forms are also available below as downloadable PDFs that can be completed offline: