MEDICARE: ABL HEALTH CARE, LLC

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	163WH0200X	Home Health Registered Nurse
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1134644073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABL HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	1601 BAYSHORE HWY STE 258
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-1520
Country	:	US
Telephone Number	:	650-257-0559
Fax Number	:	650-479-3464

Provider Business Practice Location Address
First Line	:	1601 BAYSHORE HWY STE 258
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-1520
Country	:	US
Telephone Number	:	650-257-0559
Fax Number	:	650-479-3464

Authorized Official
Title or Position	:	COO
Name	:	VITALIY GOFMAN
Credential	:
Telephone Number	:	650-257-0559

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	03/02/2026

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