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General NPI Number Information
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NPI Number | 1508167396
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Entity Type | Organization
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Legal Business Name | CALIFORNIA NURSING CARE SERVICES, INC.
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 4110 EDISON AVE STE 208B
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City | CHINO
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State | CA
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Zip | 91710-8410
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Country | US
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Telephone | 909-464-0500
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Fax | 909-464-0506
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Provider Business Mailing Address
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Address Line | 4110 EDISON AVE STE 208B
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City | CHINO
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State | CA
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Zip | 91710-8410
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Country | US
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Telephone | 909-464-0500
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Fax | 909-464-0506
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JERRY HERMOGINO
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Credential |
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Telephone | 909-569-2401
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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 | 550001645
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License Number State | CA
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