Healthcare Provider Details

I. General information

NPI: 1477584126
Provider Name (Legal Business Name): FINE HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 OBISPO AVE STE 101
SIGNAL HILL CA
90755-4027
US

IV. Provider business mailing address

2250 OBISPO AVE STE 101
SIGNAL HILL CA
90755-4027
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-9405
  • Fax: 562-988-6831
Mailing address:
  • Phone: 562-424-9405
  • Fax: 562-988-6831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHPC01731F
License Number StateCA

VIII. Authorized Official

Name: LYDIA CHIN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 562-424-9405