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General NPI Number Information
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NPI Number | 1518844562
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Entity Type | Organization
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Legal Business Name | BLUE WAVE HOME CARE LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1341 WINDEMERE LN
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City | TUSTIN
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State | CA
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Zip | 92780-5727
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Country | US
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Telephone | 949-285-3485
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Fax |
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Provider Business Mailing Address
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Address Line | 1341 WINDEMERE LN
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City | TUSTIN
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State | CA
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Zip | 92780-5727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREW WANG
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Credential |
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Telephone | 949-285-3485
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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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