Healthcare Provider Details

I. General information

NPI: 1861491417
Provider Name (Legal Business Name): TENDER CARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2005
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W LAS TUNAS DR 208
SAN GABRIEL CA
91776-1250
US

IV. Provider business mailing address

317 W LAS TUNAS DR 208
SAN GABRIEL CA
91776-1250
US

V. Phone/Fax

Practice location:
  • Phone: 626-943-8988
  • Fax: 626-943-8999
Mailing address:
  • Phone: 626-943-8988
  • Fax: 626-943-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980000954
License Number StateCA

VIII. Authorized Official

Name: MS. MAY LAY MAK
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 626-943-8988