MEDICARE: PACIFIC HEALTH SERVICES, 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		CA

General Provider Information

NPI Number	:	1699986034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	3407 W 6TH ST STE 512
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3407 W 6TH ST STE 512
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2552
Country	:	US
Telephone Number	:	213-387-9552
Fax Number	:	213-387-9553

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID SYLVIA
Credential	:
Telephone Number	:	213-387-9552

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	08/22/2020

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