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Organization

UNITED CARE PROVIDERS-HOLY INFANT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADOLFO J FESTEJO (VP/CFO)
(818) 802-6303
Entity
Organization

Contact information

Practice address
4710 KENMORE AVE, BALDWIN PARK, CA 91706-2309
(626) 962-8568
(626) 962-2444
Mailing address
18409 DANCY ST, ROWLAND HEIGHTS, CA 91748-4755
(626) 962-8568
(626) 962-2444

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
96000054
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LTC80016F
CA
Enumeration date
01/28/2006
Last updated
08/22/2020
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