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Request Application Forms by Mail

Medi-Cal Provider Enrollment application forms are available elsewhere on the Provider Enrollment Division web page, under the headings "Forms" and "For Providers", "Application Packages Alphabetical By Provider Type."  If you wish to request Medi-Cal provider enrollment applications be mailed to you, call the Medi-Cal Provider Service Center at (800) 541-5555 (outside of California, please call 916-636-1980). 

Last modified on: 11/6/2015 10:02 AM