MEDICARE: EXCLUSIVE CARE INTERNATIONAL,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	252Y00000X	Early Intervention Provider Agency	SP15886	CA

General Provider Information

NPI Number	:	1952846560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCLUSIVE CARE INTERNATIONAL,INC.

Provider Business Mailing Address
First Line	:	5446 AMETHYST LN
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-8731
Country	:	US
Telephone Number	:	909-334-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	14772 PIPELINE AVE STE A
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6027
Country	:	US
Telephone Number	:	909-606-0886
Fax Number	:

Authorized Official
Title or Position	:	LICENSED OCCUPATIONAL THERAPIST
Name	:	HARSHA RANA
Credential	:
Telephone Number	:	909-606-0886

Provider Enumeration Date	:	01/05/2017
Last Update Date	:	01/05/2017

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