Provider Demographics
NPI:1972675650
Name:OMID ADHC CORPORATION
Entity Type:Organization
Organization Name:OMID ADHC CORPORATION
Other - Org Name:SINAI ADULT DAY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YAFEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-933-6611
Mailing Address - Street 1:6077 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2648
Mailing Address - Country:US
Mailing Address - Phone:323-933-6611
Mailing Address - Fax:323-933-1269
Practice Address - Street 1:6077 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2648
Practice Address - Country:US
Practice Address - Phone:323-933-6611
Practice Address - Fax:323-933-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70330FMedicare ID - Type Unspecified