Healthcare Provider Details

I. General information

NPI: 1083917595
Provider Name (Legal Business Name): HOMECARE CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 N SAN ANTONIO RD STE R
LOS ALTOS CA
94022-1341
US

IV. Provider business mailing address

885 N SAN ANTONIO RD STE R
LOS ALTOS CA
94022-1341
US

V. Phone/Fax

Practice location:
  • Phone: 650-324-2600
  • Fax: 866-779-8975
Mailing address:
  • Phone: 650-324-2600
  • Fax: 866-779-8975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GREG G. HARTWELL
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 650-804-8890