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General NPI Number Information
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NPI Number | 1871629600
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Entity Type | Organization
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Legal Business Name | SAN MARINO HOME HEALTH INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 2233 HUNTINGTON DR SUITE 3
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City | SAN MARINO
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State | CA
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Zip | 91108-2655
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Country | US
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Telephone | 626-584-0635
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Fax | 626-584-0636
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Provider Business Mailing Address
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Address Line | 2233 HUNTINGTON DR SUITE 3
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City | SAN MARINO
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State | CA
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Zip | 91108-2655
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Country | US
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Telephone | 626-584-0635
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Fax | 626-584-0636
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Authorized Official
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Title or Position | CFO
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Name | MR. TINH VAN NGUYEN
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Credential |
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Telephone | 626-584-0635
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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 | 980001066
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License Number State | CA
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