Provider Demographics
NPI:1700042397
Name:EASTWEST HOMECARE ORANGE INC
Entity Type:Organization
Organization Name:EASTWEST HOMECARE ORANGE INC
Other - Org Name:INTERIM HEALTHCARE ORANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-709-3417
Mailing Address - Street 1:16429 BERWYN RD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2440
Mailing Address - Country:US
Mailing Address - Phone:562-207-6970
Mailing Address - Fax:562-207-6981
Practice Address - Street 1:23691 BIRTCHER DR
Practice Address - Street 2:A
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1770
Practice Address - Country:US
Practice Address - Phone:949-334-5770
Practice Address - Fax:949-334-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-02
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000254251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07850FMedicaid