MEDICARE: ANGELS OASIS SENIOR LIVING 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1609734177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS OASIS SENIOR LIVING LLC

Provider Business Mailing Address
First Line	:	1751 COLORADO BLVD UNIT 367
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1348
Country	:	US
Telephone Number	:	424-999-8902
Fax Number	:

Provider Business Practice Location Address
First Line	:	12018 SARAH ST
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-4131
Country	:	US
Telephone Number	:	424-999-8902
Fax Number	:

Authorized Official
Title or Position	:	LICENSEE
Name	:	ALVIN UY
Credential	:
Telephone Number	:	424-999-8902

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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