MEDICARE: CARE PROVIDER SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1124433859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE PROVIDER SERVICE

Provider Business Mailing Address
First Line	:	4509 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	323-478-7385
Fax Number	:	323-372-3895

Provider Business Practice Location Address
First Line	:	4509 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	323-478-7385
Fax Number	:	323-372-3895

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ARSINEH ALMASI
Credential	:
Telephone Number	:	323-478-7385

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	06/20/2014

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Directions to “CARE PROVIDER SERVICE ” Practice Location

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