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General NPI Number Information
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NPI Number | 1063559151
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Entity Type | Organization
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Legal Business Name | SUNSHINE EXTENDED SERVICES, INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 2501 LA HABRA BLVD SUITE 4
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City | LA HABRA
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State | CA
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Zip | 90631-4368
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Country | US
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Telephone | 562-691-3573
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Fax | 562-691-3892
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Provider Business Mailing Address
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Address Line | 2501 LA HABRA BLVD SUITE 4
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City | LA HABRA
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State | CA
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Zip | 90631-4368
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Country | US
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Telephone | 562-691-3573
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Fax | 562-691-3892
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Authorized Official
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Title or Position | STAFF ACCOUNTANT
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Name | MR. JUAN P LOPEZ
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Credential | LVN
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Telephone | 562-691-3573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 060000769
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License Number State | CA
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