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Username *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores.

E-mail address *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Password Requirements

Password must contain at least one uppercase character.
Password must be at least 7 characters in length.
Password must not contain the username.
Password must contain at least one digit.

Provide a password for the new account in both fields.

Password *

Confirm password *

Profile

Location

For providers seeking Medi-Cal reimbursement, please enter your service address. Your service address is where services are rendered – check with your Medi-Cal billing expert if you have questions.

This information will be used by the California Department of Health Care Services to verify that you are an eligible Medi-Cal Provider. For providers not seeking Medi-Cal reimbursement, please enter your service address to inform the state’s geographic analysis. This information will not be shared publicly.

Street *

Additional

City *

Country *

Postal code *

Phone Number *

Occupation/Provider Type *

Board Certification ID For Learners seeking MOC, the following questions are required.		Order
	Board name Board ID	Weight for row 1

Locale settings

Time zone

Select the desired local time and time zone. Dates and times throughout this site will be displayed using this time zone.

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Math question *

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

12 + 1 =

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Password Requirements