Healthcare Provider Details

I. General information

NPI: 1073450797
Provider Name (Legal Business Name): MORENO VALLEY AULT HEALTH DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 PECAN ST
CYPRESS CA
90630-2931
US

IV. Provider business mailing address

9330 PECAN ST
CYPRESS CA
90630-2931
US

V. Phone/Fax

Practice location:
  • Phone: 714-458-2165
  • Fax:
Mailing address:
  • Phone: 714-458-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SALEM
Title or Position: DIRECTOR
Credential:
Phone: 714-458-2165