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NPI Code Detail

MEDICARE: LOTUS IN-HOME CARE INC.

MEDICARE: LOTUS IN-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
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1194700873OTHERCACALIFORNIA DEPARTMENT OF SOCIAL NSERVICES

General Provider Information

NPI Number : 1528778891
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOTUS IN-HOME CARE INC.
Provider Business Mailing Address
First Line : 4205 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-3407
Country : US
Telephone Number : 323-309-6539
Fax Number :
Provider Business Practice Location Address
First Line : 4205 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-3407
Country : US
Telephone Number : 323-309-6539
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. AYUB HASSAN
Credential :
Telephone Number : 323-309-6539
Provider Enumeration Date : 11/28/2022
Last Update Date : 11/28/2022

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Directions to “LOTUS IN-HOME CARE INC. ” Practice Location

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