Provider Demographics
NPI:1619025848
Name:MASTER ENTERPRISE
Entity Type:Organization
Organization Name:MASTER ENTERPRISE
Other - Org Name:MASTER HEALTHCARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:SOLEDAD
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:626-919-6923
Mailing Address - Street 1:1430 E MAPLEGROVE ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1212
Mailing Address - Country:US
Mailing Address - Phone:626-919-6923
Mailing Address - Fax:626-919-0787
Practice Address - Street 1:1430 E MAPLEGROVE ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1212
Practice Address - Country:US
Practice Address - Phone:626-919-6923
Practice Address - Fax:626-919-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health