Healthcare Provider Details

I. General information

NPI: 1992829642
Provider Name (Legal Business Name): SAI HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21010 STODDARD WELLS RD
WALNUT CA
91789-1371
US

IV. Provider business mailing address

21010 E STODDARD WELLS ROAD
WALNUT CA
91789-0000
US

V. Phone/Fax

Practice location:
  • Phone: 626-859-4165
  • Fax: 626-962-1266
Mailing address:
  • Phone: 626-859-4165
  • Fax: 626-962-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number5074600001
License Number StateCA

VIII. Authorized Official

Name: MR. HARI S VELKURU
Title or Position: PRESIDENT
Credential:
Phone: 626-859-4165