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General NPI Number Information
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NPI Number | 1255755377
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Entity Type | Organization
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Legal Business Name | MISSION HOME HEALTH SERVICE, INC.
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 3250 WILSHIRE BLVD 1105
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City | LOS ANGELES
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State | CA
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Zip | 90010-1577
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Country | US
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Telephone | 213-387-4663
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Fax | 213-387-4664
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Provider Business Mailing Address
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Address Line | 3250 WILSHIRE BLVD. 1105
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City | LOS ANGELES
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State | CA
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Zip | 90010
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Country | US
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Telephone | 213-387-4663
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Fax | 213-387-4664
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. EDDIE CHOI
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Credential |
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Telephone | 213-387-4663
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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 | 680581025
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License Number State | CA
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