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General NPI Number Information
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NPI Number | 1962558239
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Entity Type | Organization
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Legal Business Name | SILVER AGE HOME HEALTH CARE AGENCY, INC.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 520 S LA FAYETTE PARK PL STE 100-B
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City | LOS ANGELES
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State | CA
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Zip | 90057-5402
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Country | US
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Telephone | 213-385-5788
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Fax | 213-385-5850
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Provider Business Mailing Address
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Address Line | 520 S LA FAYETTE PARK PL STE 100-B
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City | LOS ANGELES
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State | CA
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Zip | 90057-5402
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Country | US
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Telephone | 213-385-5788
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Fax | 213-385-5850
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ANGELITO DOMINGO TRINIDAD
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Credential |
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Telephone | 213-385-5788
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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 | 550000242
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License Number State | CA
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