Healthcare Provider Details
I. General information
NPI: 1144025214
Provider Name (Legal Business Name): HORIZON PEAK HEALTH - NURSING CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29000 S WESTERN AVE STE 205
RANCHO PALOS VERDES CA
90275-0890
US
IV. Provider business mailing address
1540 E INDUSTRIAL ST APT 427
LOS ANGELES CA
90021-1137
US
V. Phone/Fax
- Phone: 310-955-1041
- Fax: 323-693-9202
- Phone: 213-948-8319
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CANYBEC
SULAYMAN
Title or Position: PRESIDENT
Credential: NP
Phone: 213-948-8319