Healthcare Provider Details

I. General information

NPI: 1396732046
Provider Name (Legal Business Name): EMPRESS CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 S BASCOM AVE
SAN JOSE CA
95128-3514
US

IV. Provider business mailing address

1937 PONTIUS AVE
LOS ANGELES CA
90025-5611
US

V. Phone/Fax

Practice location:
  • Phone: 408-287-0616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JENQ H. CHEN
Title or Position: OWNER
Credential:
Phone: 310-889-9929