Healthcare Provider Details

I. General information

NPI: 1295408557
Provider Name (Legal Business Name): MEDCARE HOUSE CALL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2021
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 WESTVALE RD
DUARTE CA
91010-3618
US

IV. Provider business mailing address

PO BOX 703
DUARTE CA
91009-0703
US

V. Phone/Fax

Practice location:
  • Phone: 626-252-0994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LABAO
Title or Position: CEO/NURSE PRACTITIONER
Credential: AGACNP
Phone: 626-252-0994