Healthcare Provider Details

I. General information

NPI: 1801899414
Provider Name (Legal Business Name): MYT HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 EL PRADO AVE
TORRANCE CA
90501-2716
US

IV. Provider business mailing address

1349 EL PRADO AVE
TORRANCE CA
90501-2716
US

V. Phone/Fax

Practice location:
  • Phone: 310-618-9555
  • Fax: 310-618-0614
Mailing address:
  • Phone: 310-618-9555
  • Fax: 310-618-0614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAHZAD KHAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 917-545-8591