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General NPI Number Information
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NPI Number | 1205310984
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Entity Type | Organization
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Legal Business Name | SIERRA WEST HOME CARE, INC.
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 1750 14TH ST STE A
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City | SANTA MONICA
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State | CA
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Zip | 90404-4353
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Country | US
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Telephone | 310-313-0600
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Fax | 310-313-0677
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Provider Business Mailing Address
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Address Line | 1750 14TH ST STE A
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City | SANTA MONICA
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State | CA
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Zip | 90404-4353
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Country | US
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Telephone | 310-313-0600
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Fax | 310-313-0677
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. TIMOTHY PELTIN
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Credential |
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Telephone | 310-313-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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