Provider Demographics
NPI:1700059631
Name:ALL CARE HOME HEALTH OF SAN GABRIEL
Entity Type:Organization
Organization Name:ALL CARE HOME HEALTH OF SAN GABRIEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:APOLONIO
Authorized Official - Middle Name:COMIA
Authorized Official - Last Name:PAGSISIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-571-0387
Mailing Address - Street 1:3505 HART AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2061
Mailing Address - Country:US
Mailing Address - Phone:626-571-0387
Mailing Address - Fax:626-571-0617
Practice Address - Street 1:3505 HART AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2061
Practice Address - Country:US
Practice Address - Phone:626-571-0387
Practice Address - Fax:626-571-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001398251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679539456OtherOLD NPI NUMBER
CAHHA08141FMedicaid
CA058141Medicare PIN