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General NPI Number Information
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NPI Number | 1366240483
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Entity Type | Organization
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Legal Business Name | SOUTH BAY HOME CARE LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 2975 BOWERS AVE STE 215
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City | SANTA CLARA
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State | CA
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Zip | 95051-0955
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Country | US
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Telephone | 408-792-6138
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Fax | 650-744-0094
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Provider Business Mailing Address
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Address Line | 2975 BOWERS AVE STE 215
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City | SANTA CLARA
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State | CA
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Zip | 95051-0955
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Country | US
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Telephone | 408-792-6138
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Fax | 650-744-0094
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Authorized Official
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Title or Position | CEO
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Name | ANASTASIA KHAN
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Credential |
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Telephone | 240-760-9848
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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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