MEDICARE: SORORES 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	261QA0600X	Adult Day Care Clinic/Center	060000866	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669576724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SORORES INC

Provider Business Mailing Address
First Line	:	433 S NORMANDIE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2906
Country	:	US
Telephone Number	:	213-383-0900
Fax Number	:	213-383-7085

Provider Business Practice Location Address
First Line	:	433 S NORMANDIE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2906
Country	:	US
Telephone Number	:	213-383-0900
Fax Number	:	213-383-7085

Authorized Official
Title or Position	:	C.E.O.
Name	:	YOOMI KIM
Credential	:
Telephone Number	:	213-383-0900

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	07/22/2024

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