Healthcare Provider Details

I. General information

NPI: 1083477970
Provider Name (Legal Business Name): ATIYA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25255 CABOT RD STE 221
LAGUNA HILLS CA
92653-5529
US

IV. Provider business mailing address

25255 CABOT RD STE 221
LAGUNA HILLS CA
92653-5529
US

V. Phone/Fax

Practice location:
  • Phone: 949-259-0989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMI BEYDOUN
Title or Position: CEO
Credential: MBA
Phone: 949-259-0990