Healthcare Provider Details

I. General information

NPI: 1467370288
Provider Name (Legal Business Name): KIZUNA HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18349 AMIE AVE
TORRANCE CA
90504-4603
US

IV. Provider business mailing address

3841 CREST RD
RANCHO PALOS VERDES CA
90275-6368
US

V. Phone/Fax

Practice location:
  • Phone: 310-214-2659
  • Fax:
Mailing address:
  • Phone: 310-991-2937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: WYATT LOO
Title or Position: MEMBER
Credential:
Phone: 310-991-2937