Healthcare Provider Details

I. General information

NPI: 1083547889
Provider Name (Legal Business Name): EVEREST TUSTIN BLESSING STAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 BRYAN AVE
TUSTIN CA
92780-4464
US

IV. Provider business mailing address

801 S GARFIELD AVE STE 308
ALHAMBRA CA
91801-4486
US

V. Phone/Fax

Practice location:
  • Phone: 714-627-5947
  • Fax: 714-573-4689
Mailing address:
  • Phone: 626-228-8782
  • 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: CHARLENE LEE
Title or Position: COO
Credential:
Phone: 626-228-8782