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General NPI Number Information
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NPI Number | 1689737991
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Entity Type | Organization
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Legal Business Name | ULTIMATE CAREGIVERS
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3313 ARTHUR MACARTHUR RD
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City | SAN PEDRO
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State | CA
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Zip | 90731-6771
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Country | US
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Telephone | 562-400-8241
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 ARTHUR MACARTHUR RD
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City | SAN PEDRO
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State | CA
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Zip | 90731-6771
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Country | US
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Telephone | 562-400-8241
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FREDERICK NELSON WILSON
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Credential |
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Telephone | 562-400-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State | CA
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