MEDICARE: IDEAL HEALTHCARE STAFF PROVIDERS

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	251E00000X	Home Health Agency	SRAS99897664	CA

General Provider Information

NPI Number	:	1194035428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IDEAL HEALTHCARE STAFF PROVIDERS

Provider Business Mailing Address
First Line	:	3986 WESTSIDE AVE
Second Line	:	SUITE B
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2630
Country	:	US
Telephone Number	:	213-603-1789
Fax Number	:	323-292-3529

Provider Business Practice Location Address
First Line	:	3986 WESTSIDE AVE
Second Line	:	SUITE B
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2630
Country	:	US
Telephone Number	:	213-603-1789
Fax Number	:	323-292-3529

Authorized Official
Title or Position	:	CEO
Name	:	VICTOR OKECHUKWU AHAIWE
Credential	:	LVN, BS
Telephone Number	:	213-603-1789

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	10/20/2010

Similar Medicare Providers

1568326981 — RODNEY RODRIGUEZ MS, RDN
Practice Location Address:

2743 WINTER ST
LOS ANGELES, CA
90033-2630

Practice Phone: 323-580-3454
Practice Fax:

1700906229 — SNUO MEDICAL SERVICES, INC.
Practice Location Address:

6420 S NORMANDIE AVE
LOS ANGELES, CA
90044-2630

Practice Phone: 323-753-7766
Practice Fax: 323-753-7767

1922120443 — LAUREN HINES
Practice Location Address:

11502 S. VERMONT AVE
LOS ANGELES, CA
90044-2630

Practice Phone: 323-755-2742
Practice Fax: 310-876-0533

1093970378 — MR. JAN-KEES GEORGE VAN DER GAAG MSW, LCSW
Practice Location Address:

2630 HOLLYRIDGE DRIVE
LOS ANGELES, CA
90068

Practice Phone: 323-487-1784
Practice Fax: 310-423-7169

1013586619 — CALIWAY HOSPICE CARE
Practice Location Address:

811 WILSHIRE BLVD STE 1716
LOS ANGELES, CA
90017-2630

Practice Phone: 213-802-0609
Practice Fax: 213-600-0309

1144934084 — NICOLE S SOSA CARDENAS
Practice Location Address:

1832 W 79TH ST
LOS ANGELES, CA
90047-2630

Practice Phone: 213-833-8264
Practice Fax:

Directions to “IDEAL HEALTHCARE STAFF PROVIDERS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.