Provider Demographics
NPI:1831399013
Name:CLINICIAN HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:CLINICIAN HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:SOLEDAD
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CGFM
Authorized Official - Phone:626-512-5434
Mailing Address - Street 1:555 W LAMBERT RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3917
Mailing Address - Country:US
Mailing Address - Phone:714-255-8008
Mailing Address - Fax:714-255-8088
Practice Address - Street 1:555 W LAMBERT RD
Practice Address - Street 2:SUITE I
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3917
Practice Address - Country:US
Practice Address - Phone:714-255-8008
Practice Address - Fax:714-255-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059112Medicare Oscar/Certification