MEDICARE: FAST RECOVERY 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

General Provider Information

NPI Number	:	1639661408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAST RECOVERY HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	4221 WILSHIRE BLVD STE 170-8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3519
Country	:	US
Telephone Number	:	818-245-5367
Fax Number	:	818-854-7669

Provider Business Practice Location Address
First Line	:	4221 WILSHIRE BLVD STE 170-8
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3519
Country	:	US
Telephone Number	:	818-245-5367
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JUN YOUNG KIM
Credential	:
Telephone Number	:	818-245-5367

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	12/13/2023

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