Provider Demographics
NPI:1225280951
Name:MALLARI HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MALLARI HEALTHCARE, INC.
Other - Org Name:LIFEGUARD HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROEL
Authorized Official - Middle Name:J M
Authorized Official - Last Name:MALLARI
Authorized Official - Suffix:
Authorized Official - Credentials:BS CIVIL ENGINEERING
Authorized Official - Phone:925-271-0221
Mailing Address - Street 1:6700 KOLL CENTER PKWY STE 116
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7034
Mailing Address - Country:US
Mailing Address - Phone:925-271-0221
Mailing Address - Fax:925-800-3093
Practice Address - Street 1:6700 KOLL CENTER PKWY STE 116
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7034
Practice Address - Country:US
Practice Address - Phone:925-271-0221
Practice Address - Fax:925-800-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059055Medicare Oscar/Certification