MEDICARE: SOLORA HOME 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508665951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLORA HOME CARE LLC

Provider Business Mailing Address
First Line	:	8335 WINNETKA AVE # 276
Second Line	:
City	:	WINNETKA
State	:	CA
Zip	:	91306-1630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21255 BURBANK BLVD STE 120
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6669
Country	:	US
Telephone Number	:	408-807-6935
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	WASEEM BALLOU
Credential	:
Telephone Number	:	408-807-6935

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/10/2025

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