Provider Demographics
NPI:1770749459
Name:MAGNIFICENT HEALTCARE SYSTEMS, INC
Entity type:Organization
Organization Name:MAGNIFICENT HEALTCARE SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF PATIENT C
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:GUMPAL
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:805-526-6888
Mailing Address - Street 1:5924 E. LOS ANGELES ST
Mailing Address - Street 2:SUITE S
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063
Mailing Address - Country:US
Mailing Address - Phone:805-526-6888
Mailing Address - Fax:805-526-3888
Practice Address - Street 1:5924 E LOS ANGELES ST
Practice Address - Street 2:SUITE S
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063
Practice Address - Country:US
Practice Address - Phone:805-526-6888
Practice Address - Fax:805-526-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059244Medicare PIN