Provider Demographics
NPI:1508065616
Name:G&A SENIOR CARE
Entity Type:Organization
Organization Name:G&A SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-280-0200
Mailing Address - Street 1:1749 POTRERO GRANDE DR
Mailing Address - Street 2:SUITE#A1
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-5859
Mailing Address - Country:US
Mailing Address - Phone:626-280-0200
Mailing Address - Fax:626-280-0205
Practice Address - Street 1:1749 POTRERO GRANDE DR
Practice Address - Street 2:SUITE#A1
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-5859
Practice Address - Country:US
Practice Address - Phone:626-280-0200
Practice Address - Fax:626-280-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5976270001Medicare NSC