MEDICARE: HAYIM TOVIM 2 ADHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	0600001833	CA

General Provider Information

NPI Number	:	1023356706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYIM TOVIM 2 ADHC

Provider Business Mailing Address
First Line	:	1061 S FAIRFAX AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4402
Country	:	US
Telephone Number	:	310-420-4449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 S FAIRFAX AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4402
Country	:	US
Telephone Number	:	310-420-4449
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DANIEL SABZEROU
Credential	:
Telephone Number	:	310-420-4449

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	12/17/2013

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