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General NPI Number Information
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NPI Number | 1508929340
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Entity Type | Organization
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Legal Business Name | PACIFIC GIS DBA SULTAN ADULT DAY HEALTH CARE CENTER
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 125 W CERRITOS AVE
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City | ANAHEIM
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State | CA
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Zip | 92805-6547
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Country | US
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Telephone | 714-778-9000
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Fax | 714-778-9010
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Provider Business Mailing Address
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Address Line | 125 W CERRITOS AVE
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City | ANAHEIM
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State | CA
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Zip | 92805-6547
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Country | US
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Telephone | 714-778-9000
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Fax | 714-778-9010
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ZOHREH SHAYAN
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Credential |
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Telephone | 714-778-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 060000865
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License Number State | CA
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