Provider Demographics
NPI:1639637648
Name:KRISTA CARE LLC
Entity Type:Organization
Organization Name:KRISTA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SOFYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-684-2647
Mailing Address - Street 1:630 W DUARTE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7604
Mailing Address - Country:US
Mailing Address - Phone:626-684-2647
Mailing Address - Fax:
Practice Address - Street 1:630 W DUARTE RD STE 206
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7604
Practice Address - Country:US
Practice Address - Phone:626-684-2647
Practice Address - Fax:626-348-8679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care