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General NPI Number Information
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NPI Number | 1306456165
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Entity Type | Organization
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Legal Business Name | BAMA STREET INVESTMENTS LLC
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Dates
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Enumeration Date | 08/06/2020
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 7840 MISSION CENTER CT STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92108-1320
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Country | US
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Telephone | 619-880-5334
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Fax | 619-877-6265
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Provider Business Mailing Address
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Address Line | 7840 MISSION CENTER CT STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92108-1320
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Country | US
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Telephone | 619-880-5334
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Fax | 619-877-6265
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Authorized Official
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Title or Position | CEO
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Name | PREMAL DESAI
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Credential |
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Telephone | 702-285-3259
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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 |
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License Number State |
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Taxonomy #2
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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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