Provider Demographics
NPI:1225059363
Name:BAYCAL HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:BAYCAL HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHU
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-414-0019
Mailing Address - Street 1:1605 S MAIN ST
Mailing Address - Street 2:105
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6270
Mailing Address - Country:US
Mailing Address - Phone:408-414-0019
Mailing Address - Fax:888-205-4818
Practice Address - Street 1:1605 S MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6270
Practice Address - Country:US
Practice Address - Phone:408-414-0019
Practice Address - Fax:888-205-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000637251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000637Medicaid
CA059051Medicare Oscar/Certification