Provider Demographics
NPI:1386631091
Name:D & C CARE CENTER INC.
Entity type:Organization
Organization Name:D & C CARE CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUHN
Authorized Official - Middle Name:SORIANO
Authorized Official - Last Name:CAYABYAB
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:626-798-1175
Mailing Address - Street 1:1640 N FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1615
Mailing Address - Country:US
Mailing Address - Phone:626-798-1175
Mailing Address - Fax:626-798-3810
Practice Address - Street 1:1640 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1615
Practice Address - Country:US
Practice Address - Phone:626-798-1175
Practice Address - Fax:626-798-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55213HMedicaid
CALTC55213HMedicaid