Healthcare Provider Details

I. General information

NPI: 1285040311
Provider Name (Legal Business Name): YOKOSO HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15115 S VERMONT AVE
GARDENA CA
90247-4101
US

IV. Provider business mailing address

15115 S VERMONT AVE
GARDENA CA
90247-4101
US

V. Phone/Fax

Practice location:
  • Phone: 310-532-0700
  • Fax: 310-532-0001
Mailing address:
  • Phone: 310-532-0700
  • Fax: 310-532-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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