Basic Information
| Provider Information | |||||||||
| NPI: | 1841283025 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | POST OPERATIVE CARE ASSOCIATES | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | POST OPERATIVE CARE ASSOCIATES (PCA HOME CARE) | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 295 W CROMWELL AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937116167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594322257 | ||||||||
| FaxNumber: | 5594322469 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 W CROMWELL AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937116167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594322257 | ||||||||
| FaxNumber: | 5594322469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 02/21/2008 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VASINDA | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | SAIA | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5594322257 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | CA | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | HHA57764F | 05 | CA | MEDICAID |