Healthcare Provider Details

I. General information

NPI: 1003657958
Provider Name (Legal Business Name): COVERED CAREGIVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BUSINESS CENTER CIR STE 204
NEWBURY PARK CA
91320-1245
US

IV. Provider business mailing address

1000 BUSINESS CENTER CIR STE 204
NEWBURY PARK CA
91320-1245
US

V. Phone/Fax

Practice location:
  • Phone: 805-375-4725
  • 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
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: OHAD J PEARL
Title or Position: PRESIDENT
Credential: MPH
Phone: 805-375-4725