Healthcare Provider Details

I. General information

NPI: 1760608145
Provider Name (Legal Business Name): MILLENNIUM ADULT HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 COOK AVE.
PASADENA CA
91107-7322
US

IV. Provider business mailing address

136 COOK AVE.
PASADENA CA
91107-7322
US

V. Phone/Fax

Practice location:
  • Phone: 626-356-3838
  • Fax:
Mailing address:
  • Phone: 626-356-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHIA-LING CHEN
Title or Position: C.F.O.
Credential:
Phone: 626-356-3838