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General NPI Number Information
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NPI Number | 1649263492
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Entity Type | Organization
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Legal Business Name | CCAM, INC.
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 8929 S SEPULVEDA BLVD #306
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City | WESTCHESTER
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State | CA
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Zip | 90045-3616
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Country | US
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Telephone | 310-641-4100
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Fax | 310-670-9944
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Provider Business Mailing Address
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Address Line | 8929 S SEPULVEDA BLVD #306
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City | WESTCHESTER
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State | CA
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Zip | 90045-3616
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Country | US
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Telephone | 310-641-4100
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Fax | 310-670-9944
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Authorized Official
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Title or Position | CEO
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Name | MS. OMID GABBAI
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Credential |
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Telephone | 310-641-4100
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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 | 980001124
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License Number State | CA
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