Provider Demographics
NPI:1841694536
Name:SOUTH BAY HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:SOUTH BAY HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIZAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-999-9118
Mailing Address - Street 1:16617 YUKON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1314
Mailing Address - Country:US
Mailing Address - Phone:310-999-9118
Mailing Address - Fax:
Practice Address - Street 1:13633 INGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5610
Practice Address - Country:US
Practice Address - Phone:310-999-9118
Practice Address - Fax:310-263-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health