Healthcare Provider Details

I. General information

NPI: 1962033951
Provider Name (Legal Business Name): AMBASSADORE HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 ATLANTIC AVE STE 223
LONG BEACH CA
90807-3535
US

IV. Provider business mailing address

3939 ATLANTIC AVE STE 223
LONG BEACH CA
90807-3535
US

V. Phone/Fax

Practice location:
  • Phone: 562-409-4110
  • Fax: 562-286-8950
Mailing address:
  • Phone: 562-409-4110
  • Fax: 562-286-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EMMALYN VANO ALCANTARA
Title or Position: ADMINISTRATOR/CEO
Credential: ADMINISTRATOR
Phone: 310-713-9968