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  7. NPI Record 1629124557

MBC HOME HEALTH SERVICES, INC.
Complete NPI Record 1629124557
Home Health in Los Angeles, CA

NPI Status: Active since January 25, 2007

Contact Information

2777 WEST BROADWAY
LOS ANGELES, CA
ZIP 90041
Phone: (323) 254-5399
Fax: (323) 254-5624

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Middle Name
  24. Authorized Official Title or Position
  25. Authorized Official Telephone Number
  26. Healthcare Provider Taxonomy Code 1
  27. Provider License Number 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Is Organization Subpart
  31. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1629124557. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1629124557
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Entity Type Code: 2
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Employer Identification Number EIN: UNAVAIL
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Line Business Mailing Address: 2777 WEST BROADWAY
The city name in the location address of the provider being identified.
Provider Business Mailing Address City Name: LOS ANGELES
The State code in the location of the provider being identified.
Provider Business Mailing Address State Name: CA
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Postal Code: 900411038
The country code in the location address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 3232545399
The fax number associated with the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 3232545624
The date the provider was assigned a unique identifier (assigned an NPI).
Provider First Line Business Practice Location Address: 2777 WEST BROADWAY
The date that a record was last updated or changed.
Provider Business Practice Location Address City Name: LOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 900411038
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3232545399
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3232545624
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/25/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 9/11/2009
The date that a record was last updated or changed.
Authorized Official Last Name: DIZON
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: REYNALDO
The first name of the authorized official.
Authorized Official Middle Name: C
The middle name of the authorized official.
Authorized Official Title or Position: PRESIDENT
The title or position of the authorized official.
Authorized Official Telephone Number: 3232545399
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 251E00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 550000091
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: CA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: MR.