Provider Demographics
NPI:1558369603
Name:DAIAN CORPORATION
Entity Type:Organization
Organization Name:DAIAN CORPORATION
Other - Org Name:PEC HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:LU
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-590-3620
Mailing Address - Street 1:10507 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1128
Mailing Address - Country:US
Mailing Address - Phone:714-689-2300
Mailing Address - Fax:714-689-2301
Practice Address - Street 1:10507 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1128
Practice Address - Country:US
Practice Address - Phone:714-689-2300
Practice Address - Fax:714-689-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000034251E00000X
CA250000792251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07567HMedicaid
CA060000034OtherSTATE LICENSE
CA057567Medicare Oscar/Certification
CA057567Medicare ID - Type UnspecifiedHOME HEALTH
CA060000034Medicaid