Healthcare Provider Details

I. General information

NPI: 1215141569
Provider Name (Legal Business Name): HARMONY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 N MCCARTHY BLVD SUITE 220
MILPITAS CA
95035-5119
US

IV. Provider business mailing address

1702L MERIDIAN AVE # 296
SAN JOSE CA
95125-5534
US

V. Phone/Fax

Practice location:
  • Phone: 408-676-8140
  • Fax: 866-430-3312
Mailing address:
  • Phone: 408-676-8140
  • Fax: 866-430-3312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA67246
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier004271673
Identifier TypeMEDICAID
Identifier StateCT
Identifier Issuer
# 2
IdentifierDG3100
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerMEDICARE RAILROAD

VIII. Authorized Official

Name: DR. JENELYN CHING LIM
Title or Position: OWNER
Credential: M.D.
Phone: 408-676-8140