Healthcare Provider Details

I. General information

NPI: 1366908410
Provider Name (Legal Business Name): RIO HONDO HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13007 PARAMOUNT BLVD
DOWNEY CA
90242-4329
US

IV. Provider business mailing address

13007 PARAMOUNT BLVD
DOWNEY CA
90242-4329
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-9301
  • Fax: 562-904-8005
Mailing address:
  • Phone: 562-923-9301
  • Fax: 562-904-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: TREASURER
Credential:
Phone: 949-540-1249