Provider Demographics
NPI:1457683237
Name:THE PARADISE
Entity Type:Organization
Organization Name:THE PARADISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:714-293-8818
Mailing Address - Street 1:569 S SATE COLLEGE BLVD.
Mailing Address - Street 2:STE. 51
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831
Mailing Address - Country:US
Mailing Address - Phone:714-879-1956
Mailing Address - Fax:
Practice Address - Street 1:659 S SATE COLLEGE BLVD.
Practice Address - Street 2:STE. 51
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831
Practice Address - Country:US
Practice Address - Phone:714-879-1956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101327406332B00000X, 332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals