Healthcare Provider Details

I. General information

NPI: 1043351885
Provider Name (Legal Business Name): OCEAN COMMUNITY CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 18TH ST
SANTA MONICA CA
90404-2804
US

IV. Provider business mailing address

1448 18TH STREET
SANTA MONICA CA
90404-2804
US

V. Phone/Fax

Practice location:
  • Phone: 310-586-7607
  • Fax: 310-586-7600
Mailing address:
  • Phone: 310-586-7607
  • Fax: 310-586-7600

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: MR. ROBERT MATZ
Title or Position: OWNER
Credential:
Phone: 818-825-0526