| NPI | 1114794138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILMER A HERNANDEZ Authorized Official 714-499-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 305R00000X Preferred Provider Organization | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363A00000X Physician Assistant | |
| 385H00000X Respite Care | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2024-04-26 |