Provider Demographics
NPI:1821330325
Name:UNIVERSAL HEALTH NET
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH NET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMENEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSAFIEH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:949-690-5224
Mailing Address - Street 1:2099 S STATE COLLEGE BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-0189
Mailing Address - Country:US
Mailing Address - Phone:949-609-9693
Mailing Address - Fax:714-786-8671
Practice Address - Street 1:2400 E KATELLA AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5945
Practice Address - Country:US
Practice Address - Phone:949-690-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597438251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based