- Enrollment id
- O20201205000013
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1285132761
- Multiple npi flag
- N
- Ccn
- 559674
- Associate id
- 4789095266
- Organization name
- CALIMED HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 664 W BROADWAY
- Address line 2
- STE F
- City
- GLENDALE
- State
- CA
- Zip code
- 912041097