1487786166 NPI number — ENKI HEALTH SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487786166 NPI number — ENKI HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENKI HEALTH SERVICES, 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:
6
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:
1487786166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 E OLIVE AVE
Provider Second Line Business Mailing Address:
#203
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91502-1846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-973-4899
Provider Business Mailing Address Fax Number:
818-973-4888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3208 ROSEMEAD BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
EL MONTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91731-2830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-227-7001
Provider Business Practice Location Address Fax Number:
626-227-7002
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SERRANO
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
COS
Authorized Official Telephone Number:
818-973-4899

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000007452 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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