SAN MARINO HOME HEALTH INC NPI 1871629600

Home Health in San Marino, CA

NPI 1871629600 Organization Home Health CLIA Number 05D0919632 CLIA Certificate of Waiver

About SAN MARINO HOME HEALTH INC

San Marino Home Health Inc is a provider established in San Marino, California specializing in home health. The NPI number of San Marino Home Health Inc is 1871629600 and was assigned on February 2007. The practitioner's primary taxonomy code is 251E00000X with license number 980001066 (CA). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mr. Tinh Van Nguyen (Cfo)

The CLIA number of San Marino Home Health Inc is 05D0919632 registered as a "home health agency" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to San Marino Home Health Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1871629600

Provider NameSAN MARINO HOME HEALTH INC
Provider Location Address2233 HUNTINGTON DR SUITE 3 SAN MARINO, CA 91108
Provider Mailing Address2233 HUNTINGTON DR SUITE 3 SAN MARINO, CA 91108
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-26-2007
Last Update Date05-02-2008


Primary Taxonomy

Taxonomy Code251E00000X
ClassificationHome Health
TypeAgencies
License No.980001066
License StateCA
Taxonomy DescriptionA public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Business Address

SAN MARINO HOME HEALTH INC
2233 HUNTINGTON DR
SUITE 3
SAN MARINO, CA
ZIP 91108
Phone: (626) 584-0635
Fax: (626) 584-0636

Get Directions


Mailing Address

SAN MARINO HOME HEALTH INC
2233 HUNTINGTON DR
SUITE 3
SAN MARINO, CA
ZIP 91108
Phone: (626) 584-0635
Fax: (626) 584-0636



Authorized Official

Authorized Official NameMR. TINH VAN NGUYEN
Authorized Official TitleCFO
Authorized Official Phone(626) 584-0635

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1871629600 is:

CLIA Number05D0919632
Facility TypeHOME HEALTH AGENCY
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
058030MEDICARE ID-TYPE UNSPECIFIED (04)CA

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1730195686 PAUL T LIU M.D.
Individual
Internal Medicine (Geriatric Medicine)2233 HUNTINGTON DR # 12
SAN MARINO, CA 91108
(626) 796-0821
1295934792PAUL TC LIU MD, INC
Organization
Specialist2233 HUNTINGTON DR SUITE 10
SAN MARINO, CA 91108
(626) 796-0821
1164544094REGENCY THERAPY RESOURCES
Organization
Occupational Therapy Assistant2233 HUNTINGTON DR SUITE 19
SAN MARINO, CA 91108
(626) 486-0775

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.