Provider Demographics
NPI:1285637603
Name:PROMPTCARE HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:PROMPTCARE HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PERFECTO
Authorized Official - Middle Name:F
Authorized Official - Last Name:GALLARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-500-1902
Mailing Address - Street 1:454 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-4760
Mailing Address - Country:US
Mailing Address - Phone:818-500-1902
Mailing Address - Fax:
Practice Address - Street 1:454 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4760
Practice Address - Country:US
Practice Address - Phone:818-500-1902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557773Medicare ID - Type UnspecifiedMEDICARE PROVIDER