Healthcare Provider Details

I. General information

NPI: 1508281346
Provider Name (Legal Business Name): KALI TICHI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 WESTWOOD BLVD STE 210
LOS ANGELES CA
90064-2000
US

IV. Provider business mailing address

2288 WESTWOOD BLVD STE 210
LOS ANGELES CA
90064-2000
US

V. Phone/Fax

Practice location:
  • Phone: 310-235-1111
  • Fax: 310-235-2282
Mailing address:
  • Phone: 310-235-1111
  • Fax: 310-235-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TED J PAPPAS
Title or Position: PRESIDENT
Credential:
Phone: 310-235-1111