Provider Demographics
NPI:1740632249
Name:PRESTIGE CAREGIVING AGENCY
Entity type:Organization
Organization Name:PRESTIGE CAREGIVING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-347-8700
Mailing Address - Street 1:3838 W CARSON ST STE 335
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6728
Mailing Address - Country:US
Mailing Address - Phone:424-275-4058
Mailing Address - Fax:424-275-4059
Practice Address - Street 1:3838 W CARSON ST STE 335
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6728
Practice Address - Country:US
Practice Address - Phone:424-275-4058
Practice Address - Fax:424-275-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care