Healthcare Provider Details

I. General information

NPI: 1548170541
Provider Name (Legal Business Name): ONE HERITAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 BARHAM BLVD STE 105
LOS ANGELES CA
90068-3097
US

IV. Provider business mailing address

6058 FAIR AVE
NORTH HOLLYWOOD CA
91606-4231
US

V. Phone/Fax

Practice location:
  • Phone: 408-705-1838
  • 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

VIII. Authorized Official

Name: MR. DOMINIC SOO
Title or Position: PRESIDENT
Credential:
Phone: 408-705-1649