Healthcare Provider Details

I. General information

NPI: 1356622088
Provider Name (Legal Business Name): CALIFORNIA HOME CARE NURSING SERVICES INT'L CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 WILSHIRE BLVD SUITE 620
LOS ANGELES CA
90010-1824
US

IV. Provider business mailing address

3350 WILSHIRE BLVD SUITE 620
LOS ANGELES CA
90010-1824
US

V. Phone/Fax

Practice location:
  • Phone: 213-446-7776
  • Fax: 213-384-8573
Mailing address:
  • Phone: 213-446-7776
  • Fax: 213-384-8573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: KAREN MARCY S. PHAM
Title or Position: CEO
Credential:
Phone: 310-383-5077