=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083917595
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOMECARE CALIFORNIA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2010
-----------------------------------------------------
Last Update Date | 12/06/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 885 N SAN ANTONIO RD STE R
-----------------------------------------------------
City | LOS ALTOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94022-1341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-324-2600
-----------------------------------------------------
Fax | 866-779-8975
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 885 N SAN ANTONIO RD STE R
-----------------------------------------------------
City | LOS ALTOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94022-1341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-324-2600
-----------------------------------------------------
Fax | 866-779-8975
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING DIRECTOR
-----------------------------------------------------
Name | MR. GREG G. HARTWELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 650-804-8890
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------