Basic Information
| Provider Information | |||||||||
| NPI: | 1588697254 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOCUS HOME CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 177 BOVET RD FL 6 | ||||||||
| Address2: | ATTN: CD BILLING | ||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944023116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012559279 | ||||||||
| FaxNumber: | 7012224142 | ||||||||
| Practice Location | |||||||||
| Address1: | 4892 SCREECH OWL CREEK RD | ||||||||
| Address2: | |||||||||
| City: | EL DORADO HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957628073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006003554 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 09/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | COSENZA | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8006003554 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CLS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | LAB98956F | 05 | CA | MEDICAID | 05D0898956 | 01 | CA | CLIA | OTHER |