1396865234 NPI number — PACIFIC RIM HOME HEALTH INC

Table of content: (NPI 1396865234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396865234 NPI number — PACIFIC RIM HOME HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PACIFIC RIM HOME HEALTH INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396865234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2225 W COMMONWEALTH AVE STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALHAMBRA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91803-1334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-741-5264
Provider Business Mailing Address Fax Number:
626-741-5295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2225 W COMMONWEALTH AVE STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALHAMBRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91803-1334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-741-5264
Provider Business Practice Location Address Fax Number:
626-741-5295
Provider Enumeration Date:
03/31/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
TERESA
Authorized Official Title or Position:
CEO / PRESIDENT
Authorized Official Telephone Number:
626-741-5264

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 550000870 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)