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NPI Code Detail

MEDICARE: FONTANA ADULT DAY HEALTH CARE CENTER

MEDICARE: FONTANA ADULT DAY HEALTH CARE CENTER
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
1261QA0600XAdult Day Care Clinic/CenterCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093883654
Entity Type Code : Organization
Provider Name (Legal Business Name) : FONTANA ADULT DAY HEALTH CARE CENTER
Provider Business Mailing Address
First Line : 2309 DALY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2230
Country : US
Telephone Number : 323-276-8149
Fax Number : 323-276-8143
Provider Business Practice Location Address
First Line : 2309 DALY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2230
Country : US
Telephone Number : 323-276-8149
Fax Number : 323-276-8143
Authorized Official
Title or Position : CFO
Name : MR. ANTONIO ZAMORANO
Credential :
Telephone Number : 323-276-8149
Provider Enumeration Date : 12/01/2006
Last Update Date : 01/17/2008

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Directions to “FONTANA ADULT DAY HEALTH CARE CENTER ” Practice Location

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