Provider Demographics
NPI:1891732921
Name:ADMIRAL HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ADMIRAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:JAHANGARD
Authorized Official - Last Name:MAHBOOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-652-8297
Mailing Address - Street 1:4010 WATSON PLAZA DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4047
Mailing Address - Country:US
Mailing Address - Phone:562-421-0777
Mailing Address - Fax:562-421-0770
Practice Address - Street 1:4010 WATSON PLAZA DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4042
Practice Address - Country:US
Practice Address - Phone:562-421-0777
Practice Address - Fax:562-421-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000974251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57635FMedicaid
CAHHA57635FMedicaid