Healthcare Provider Details

I. General information

NPI: 1710696901
Provider Name (Legal Business Name): MEDICAL EXPERTS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12409 WILLOW FOREST DR
MOORPARK CA
93021-2763
US

IV. Provider business mailing address

12409 WILLOW FOREST DR
MOORPARK CA
93021-2763
US

V. Phone/Fax

Practice location:
  • Phone: 805-433-5260
  • Fax:
Mailing address:
  • Phone: 805-433-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. BOBBY JEFFERY HALL
Title or Position: OWNER OPERATOR
Credential: MSW
Phone: 805-433-5260