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General NPI Number Information
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NPI Number | 1629354808
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Entity Type | Organization
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Legal Business Name | EXECUTIVE HOME HEALTH, INC
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 750 S RAYMOND AVE SUITE 123
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City | PASADENA
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State | CA
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Zip | 91105-3244
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Country | US
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Telephone | 626-765-9202
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Fax | 626-765-9206
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Provider Business Mailing Address
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Address Line | 750 S RAYMOND AVE SUITE 123
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City | PASADENA
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State | CA
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Zip | 91109-3244
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Country | US
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Telephone | 626-765-9202
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Fax | 626-765-9206
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL J FRAIPONT
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Credential | MD
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Telephone | 626-765-9202
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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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