Healthcare Provider Details

I. General information

NPI: 1770749459
Provider Name (Legal Business Name): MAGNIFICENT HEALTCARE SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5924 E LOS ANGELES ST SUITE S
SIMI VALLEY CA
93063
US

IV. Provider business mailing address

5924 E. LOS ANGELES ST SUITE S
SIMI VALLEY CA
93063
US

V. Phone/Fax

Practice location:
  • Phone: 805-526-6888
  • Fax: 805-526-3888
Mailing address:
  • Phone: 805-526-6888
  • Fax: 805-526-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LOURDES GUMPAL RAMOS
Title or Position: ADMINISTRATOR/DIRECTOR OF PATIENT C
Credential: REGISTERED NURSE
Phone: 805-526-6888