Basic Information
| Provider Information | |||||||||
| NPI: | 1457354920 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HMC HEALTH CARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1291 S BERNARDO AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082458070 | ||||||||
| FaxNumber: | 4083280562 | ||||||||
| Practice Location | |||||||||
| Address1: | 1291 S BERNARDO AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082458070 | ||||||||
| FaxNumber: | 4083280562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2005 | ||||||||
| LastUpdateDate: | 04/20/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHAVEZ | ||||||||
| AuthorizedOfficialFirstName: | HERMINIA | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4082458070 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 220000422 | CA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | LTC55792F | 05 | CA | MEDICAID |