Provider Demographics
NPI:1801403506
Name:OPO HEALTH LLC
Entity Type:Organization
Organization Name:OPO HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PRINCE JOHN
Authorized Official - Middle Name:RINGOR
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-288-3088
Mailing Address - Street 1:1528 S EL CAMINO REAL STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-3067
Mailing Address - Country:US
Mailing Address - Phone:650-288-0130
Mailing Address - Fax:650-288-3088
Practice Address - Street 1:1528 S EL CAMINO REAL STE 108
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3067
Practice Address - Country:US
Practice Address - Phone:650-288-0130
Practice Address - Fax:650-288-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health