Healthcare Provider Details

I. General information

NPI: 1619244530
Provider Name (Legal Business Name): SINCERE DOMESTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 N LAKE AVE STE D
PASADENA CA
91104-4559
US

IV. Provider business mailing address

747 N LAKE AVE. # D
PASADENA CA
91104
US

V. Phone/Fax

Practice location:
  • Phone: 626-398-2098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID HE
Title or Position: MANAGER
Credential:
Phone: 626-818-1254