Provider Demographics
NPI:1538496781
Name:HEALTH CARE 21 FAMILY LP
Entity Type:Organization
Organization Name:HEALTH CARE 21 FAMILY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:YEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-284-8188
Mailing Address - Street 1:846 W VALLEY BLVD # A-B
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3233
Mailing Address - Country:US
Mailing Address - Phone:626-284-8188
Mailing Address - Fax:626-284-7017
Practice Address - Street 1:846 W VALLEY BLVD # A-B
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3233
Practice Address - Country:US
Practice Address - Phone:626-284-8188
Practice Address - Fax:626-284-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2010-12-14
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
CADME01285FMedicaid
CAZZZ24218ZOtherBLUE CROSS/BLUE SHIELD
CADME01285FMedicaid