Healthcare Provider Details

I. General information

NPI: 1215214689
Provider Name (Legal Business Name): HEALTHCARE RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2011
Last Update Date: 11/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 S ASSOCIATED RD # 287
BREA CA
92821-5802
US

IV. Provider business mailing address

417 S ASSOCIATED RD # 287
BREA CA
92821-5802
US

V. Phone/Fax

Practice location:
  • Phone: 714-488-3188
  • Fax:
Mailing address:
  • Phone: 714-488-3188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. RAYMOND N SMITH
Title or Position: PRESIDENT
Credential: FNP
Phone: 714-488-3188