Provider Demographics
NPI:1376684084
Name:STELLAR HEALTHCARE, INC.
Entity Type:Organization
Organization Name:STELLAR HEALTHCARE, INC.
Other - Org Name:KABAFUSION HH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:800-435-3020
Mailing Address - Street 1:17777 CENTER COURT DRIVE NORTH
Mailing Address - Street 2:SUITE 550
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:909-621-5188
Mailing Address - Fax:909-399-9119
Practice Address - Street 1:17777 CENTER COURT DR N STE 270
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8567
Practice Address - Country:US
Practice Address - Phone:909-621-5188
Practice Address - Fax:909-399-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000843251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA367910OtherJCAHO