1760881510 NPI number — TCM ELDERLY HOME CARE

Table of content: (NPI 1760881510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760881510 NPI number — TCM ELDERLY HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TCM ELDERLY HOME CARE
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:
1760881510
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1066 OAKPOINT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAY POINT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94565-7619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-212-5977
Provider Business Mailing Address Fax Number:
925-291-2868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
931 CAMINO RAMON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-212-5977
Provider Business Practice Location Address Fax Number:
925-291-2868
Provider Enumeration Date:
08/18/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LINGBANAN
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
MENDOZA
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
925-212-5977

Provider Taxonomy Codes

  • Taxonomy code: 320700000X , with the licence number:  075600088 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320700000X , with the licence number: 075600303 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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