Healthcare Provider Details
I. General information
NPI: 1477431732
Provider Name (Legal Business Name): OPTIMUM CARE CLHF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6735 36TH ST
JURUPA VALLEY CA
92509-1414
US
IV. Provider business mailing address
302 FAIRWAY LN
PLACENTIA CA
92870-4442
US
V. Phone/Fax
- Phone: 310-994-9181
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLAS
OUDINOT
Title or Position: OWNER
Credential:
Phone: 310-994-9181