Healthcare Provider Details

I. General information

NPI: 1295258564
Provider Name (Legal Business Name): CHINO CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 PHILADELPHIA ST. SUITE C
CHINO CA
91765
US

IV. Provider business mailing address

5402 PHILADELPHIA ST STE C
CHINO CA
91710-2489
US

V. Phone/Fax

Practice location:
  • Phone: 909-517-0087
  • Fax: 909-517-0078
Mailing address:
  • Phone: 909-517-0087
  • Fax: 909-517-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number550003893
License Number StateCA

VIII. Authorized Official

Name: ANTHONY LO
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 909-517-0087