Provider Demographics
NPI:1184105231
Name:PHYSICIANS AND SURGEONS HOME CARE INC.
Entity type:Organization
Organization Name:PHYSICIANS AND SURGEONS HOME CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT&CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-430-4513
Mailing Address - Street 1:1086 S FAIRFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-4401
Mailing Address - Country:US
Mailing Address - Phone:818-213-6325
Mailing Address - Fax:818-532-1002
Practice Address - Street 1:1086 S FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-4401
Practice Address - Country:US
Practice Address - Phone:818-213-6325
Practice Address - Fax:818-532-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA337916OtherMEDICARE NORTH CALIFORNIA
CACB308648OtherMEDICARE SOUTH CALIFORNIA