Provider Demographics
NPI:1245574011
Name:PACIFIC HOME HEALTH
Entity Type:Organization
Organization Name:PACIFIC HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-882-8466
Mailing Address - Street 1:1998 N ARROWHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4116
Mailing Address - Country:US
Mailing Address - Phone:909-882-8466
Mailing Address - Fax:909-882-9203
Practice Address - Street 1:1998 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4116
Practice Address - Country:US
Practice Address - Phone:909-882-8466
Practice Address - Fax:909-882-9203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000790251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health