1386035293 NPI number — BEST CARE HEALTH SERVICES

Table of content: (NPI 1386035293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386035293 NPI number — BEST CARE HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST CARE HEALTH SERVICES
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:
1386035293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7021 CANOGA AVE
Provider Second Line Business Mailing Address:
#B
Provider Business Mailing Address City Name:
CANOGA PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91303-3106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-914-0773
Provider Business Mailing Address Fax Number:
818-917-0776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7021 CANOGA AVE
Provider Second Line Business Practice Location Address:
#B
Provider Business Practice Location Address City Name:
CANOGA PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91303-3106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-914-0773
Provider Business Practice Location Address Fax Number:
818-917-0776
Provider Enumeration Date:
02/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SHAHRAM
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/PIC
Authorized Official Telephone Number:
818-914-0773

Provider Taxonomy Codes

  • Taxonomy code: 3336C0004X , with the licence number:  PHY 52546 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY 52546 , 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)

  • Identifier: 56-54303 . This is a "NCPDP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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