MEDICARE: PROHEALTH CARE INC

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	253Z00000X	In Home Supportive Care Agency
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1215685011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHEALTH CARE INC

Provider Business Mailing Address
First Line	:	2700 ZANKER RD STE 180
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95134-2140
Country	:	US
Telephone Number	:	408-451-9055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 ZANKER RD STE 180
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95134-2140
Country	:	US
Telephone Number	:	408-451-9055
Fax Number	:	877-867-1787

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMED MARLEEN
Credential	:
Telephone Number	:	408-451-9055

Provider Enumeration Date	:	03/11/2022
Last Update Date	:	03/20/2024

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