Provider Demographics
NPI:1144347311
Name:UNITED MEDICAL HOME CARE INC
Entity type:Organization
Organization Name:UNITED MEDICAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-754-1690
Mailing Address - Street 1:13550 ROSCOE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402
Mailing Address - Country:US
Mailing Address - Phone:818-754-1690
Mailing Address - Fax:818-989-5153
Practice Address - Street 1:13550 ROSCOE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-754-1690
Practice Address - Fax:818-989-5153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57683GMedicaid
CAHHA57683GMedicaid