MEDICARE: AMITY ELDERLY CARE SERVICES 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	171M00000X	Case Manager/Care Coordinator
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144190240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMITY ELDERLY CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	835 WILSHIRE BLVD STE 500
Second Line	:	#530
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-2656
Country	:	US
Telephone Number	:	562-625-7761
Fax Number	:

Provider Business Practice Location Address
First Line	:	11943 207 STREET
Second Line	:	APT C
City	:	LAKEWOOD
State	:	CA
Zip	:	90715
Country	:	US
Telephone Number	:	562-625-7761
Fax Number	:

Authorized Official
Title or Position	:	OPERATION MANAGER
Name	:	MR. ISAAC ROYCE MARQUEZ PALAPAL
Credential	:
Telephone Number	:	562-625-7761

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	12/05/2025

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