Provider Demographics
NPI:1083930739
Name:UNITED PROFESSIONAL NETWORK HOME HEALTH INC
Entity Type:Organization
Organization Name:UNITED PROFESSIONAL NETWORK HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADALBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:909-904-0829
Mailing Address - Street 1:16689 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-8414
Mailing Address - Country:US
Mailing Address - Phone:909-904-0829
Mailing Address - Fax:909-586-9197
Practice Address - Street 1:16689 FOOTHILL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-8414
Practice Address - Country:US
Practice Address - Phone:909-904-0829
Practice Address - Fax:909-586-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health