Healthcare Provider Details

I. General information

NPI: 1205834322
Provider Name (Legal Business Name): LIFEMEDICALHOMECARESERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 IMPERIAL HWY
DOWNEY CA
90242-3713
US

IV. Provider business mailing address

8051 IMPERIAL HWY
DOWNEY CA
90242-3713
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-1000
  • Fax: 562-904-0909
Mailing address:
  • Phone: 562-904-1000
  • Fax: 562-904-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number100453
License Number StateCA

VIII. Authorized Official

Name: MRS. FAKHRI FAITH SOLTANI
Title or Position: GENERAL MANAGER
Credential:
Phone: 562-904-1000