Bradbourne Healthcare, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001488 Issued in CA

Legal business name

BRADBOURNE HEALTHCARE, INC.

Practice address

1109 W San Bernardino Rd Ste 230
Covina, CA 91722-4166

Phone

(626) 814-0200

Fax

(626) 814-0225

NPI assigned

Mar 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hazel De Castro, RN

Title

Administrator

Phone

(626) 814-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 058217

Legal name

BRADBOURNE HEALTHCARE, INC.

Doing business as

BRADBOURNE HEALTHCARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 26, 2003

Last certification

Nov 15, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jun 21, 2002 in CA

Enrollment address

1109 W San Bernardino Rd
Ste 230
Covina, CA 91722-4166
HHA Branch

Listed as

Bradbourne Healthcare, IncCCN 058217

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Nov 26, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Stephen Allen Boykins, DPM

  • Podiatric Assistant
  • Downey, CA
  • NPI 1689014318

  Home health agency

  Care Compare affiliation
• Norman T Chien, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Pasadena, CA
  • NPI 1184696999

  Home health agency

  Care Compare affiliation
• Han Van Duong, M.D.& D.O.

  • Internal Medicine Physician
  • Rosemead, CA
  • NPI 1013070234

  Home health agency

  Care Compare affiliation
• Stan Mathioulakis, MD

  • Internal Medicine Physician
  • Duarte, CA
  • NPI 1912080847

  Home health agency

  Care Compare affiliation
• Prasert Basil Vassantachart, MD

  • General Practice Physician
  • Alhambra, CA
  • NPI 1295720050

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1003948654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 W SAN BERNARDINO RD STE 230",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917224166",
            "telephone_number": "626-814-0200",
            "fax_number": "626-814-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W SAN BERNARDINO RD STE 230",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917224166",
            "telephone_number": "626-814-0200",
            "fax_number": "626-814-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADBOURNE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "DE CASTRO",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-814-0200",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08217F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Marie Boyd
• Nikko Van Boyd
• Travis David Boyer, FNP
• Erin Oliva Boysaw
• Kristen Renee Bracamontes
• Isaiah Eric Bradford
• George Charles Bradley, DDS
• George F Brady Jr.
• Graciela Guadalupe Brambila
• Ruby Bran

• Home Health Agency in Covina, CA
• Providers in Covina, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.