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NPI 1093051161

NPI 1093051161 : MOGEN DAVID TENDER CARE LLC : BURBANK, CA

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General NPI Number Information
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    NPI Number           |    1093051161
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    Entity Type          |    Organization 
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    Legal Business Name  |    MOGEN DAVID TENDER CARE LLC 
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Dates
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    Enumeration Date     |    12/18/2012
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    Last Update Date     |    12/18/2012
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Provider Practice Location Address
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    Address Line         |    713 N CALIFORNIA ST 
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    City                 |    BURBANK
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    State                |    CA
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    Zip                  |    91505-2937
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    Country              |    US
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    Telephone            |    818-566-1785
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    713 N CALIFORNIA ST 
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    City                 |    BURBANK
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    State                |    CA
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    Zip                  |    91505-2937
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    Country              |    US
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    Telephone            |    818-566-1785
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. ANDREW  TEPPER 
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    Credential           |    
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    Telephone            |    818-566-1785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    372600000X
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    Taxonomy Name        |    Adult Companion
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    376J00000X
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    Taxonomy Name        |    Homemaker
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    
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