Healthcare Provider Details

I. General information

NPI: 1215425517
Provider Name (Legal Business Name): CASA DEL SOL ADULT DAY HEALTH CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 W BEVERLY BLVD
MONTEBELLO CA
90640-2308
US

IV. Provider business mailing address

10429 EASTBORNE AVE
LOS ANGELES CA
90024-6109
US

V. Phone/Fax

Practice location:
  • Phone: 310-927-4715
  • Fax: 310-444-0066
Mailing address:
  • Phone: 310-927-4715
  • Fax: 310-444-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVAR DANIALPOUR
Title or Position: CEO
Credential:
Phone: 310-927-4715