=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245057645
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RUMI CARE CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2024
-----------------------------------------------------
Last Update Date | 12/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19730 VENTURA BLVD STE 101
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91364-2683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-247-0909
-----------------------------------------------------
Fax | 747-209-1515
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24569 CALVERT ST
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-1015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-970-7085
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MRS. YALDA HERFATMANESH
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 818-970-7085
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------