Healthcare Provider Details

I. General information

NPI: 1801554035
Provider Name (Legal Business Name): LA PALMA ADULT DAY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2021
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 NEWPORT BLVD STE 180
COSTA MESA CA
92627-2286
US

IV. Provider business mailing address

7811 COMMONWEALTH AVE
BUENA PARK CA
90621-2422
US

V. Phone/Fax

Practice location:
  • Phone: 714-521-0643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HYUN LEE
Title or Position: BOARD CHAIR
Credential:
Phone: 714-512-0016