1649843210 NPI number — CITY OF ANGELS HOME HEALTH, INC.

Table of content: (NPI 1649843210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649843210 NPI number — CITY OF ANGELS HOME HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF ANGELS 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:
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:
1649843210
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22141 VENTURA BLVD
Provider Second Line Business Mailing Address:
SUITE #207
Provider Business Mailing Address City Name:
WOODLAND HLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-914-5861
Provider Business Mailing Address Fax Number:
818-337-7406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22141 VENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE #207
Provider Business Practice Location Address City Name:
WOODLAND HLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-914-5861
Provider Business Practice Location Address Fax Number:
818-337-7406
Provider Enumeration Date:
07/21/2021

Additional Information

Authorized Official

Authorized Official Last Name:
YAZDANI
Authorized Official First Name:
ANAHITA
Authorized Official Middle Name:
Authorized Official Title or Position:
DOPCS
Authorized Official Telephone Number:
818-914-5861

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 550006425 . This is a "STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 559537 . This is a "PTAN / CCN NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 559537 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com