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NPI Code Detail

MEDICARE: PHYSICIANS AND SURGEONS HOME CARE INC.

MEDICARE: PHYSICIANS AND SURGEONS HOME 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
1208600000XSurgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CA337916OTHERCAMEDICARE NORTH CALIFORNIA
2CB308648OTHERCAMEDICARE SOUTH CALIFORNIA

General Provider Information

NPI Number : 1184105231
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS AND SURGEONS HOME CARE INC.
Provider Business Mailing Address
First Line : 1086 S FAIRFAX AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90019-4401
Country : US
Telephone Number : 818-213-6325
Fax Number : 818-532-1002
Provider Business Practice Location Address
First Line : 1086 S FAIRFAX AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90019-4401
Country : US
Telephone Number : 818-213-6325
Fax Number : 818-532-1002
Authorized Official
Title or Position : PRESIDENT&CEO
Name : MICHAEL GHODS
Credential : MD
Telephone Number : 310-430-4513
Provider Enumeration Date : 08/27/2018
Last Update Date : 01/28/2025

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