MEDICARE: STAT HOME HEALTH CARE, INC.

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	251E00000X	Home Health Agency		CA

Other Identifiers

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

General Provider Information

NPI Number	:	1154390342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAT HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	2105 BEVERLY BLVD
Second Line	:	STE. 221
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2216
Country	:	US
Telephone Number	:	213-483-2355
Fax Number	:	213-353-0831

Provider Business Practice Location Address
First Line	:	2105 BEVERLY BLVD
Second Line	:	STE. 221
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2216
Country	:	US
Telephone Number	:	213-483-2355
Fax Number	:	213-353-0831

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JUDITH RODRIGUEZ SOHAL
Credential	:
Telephone Number	:	213-483-2355

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	08/22/2020

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Directions to “STAT HOME HEALTH CARE, INC. ” Practice Location

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