NPIMap

Organization Active NPI

Egb Holdings

  • Home Health Agency
  • Costa Mesa, CA
National Provider Identifier
1023305331
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EGB HOLDINGS
Practice address
151 Kalmus Dr Ste D101
Costa Mesa, CA 92626-5959
Phone
(714) 557-5506
Fax
(714) 557-5507
NPI assigned
Jul 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Emil Bundang
Title
Ceo
Phone
(714) 557-5506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

151 Kalmus Dr Ste D101
Costa Mesa, CA 92626-5959

Mailing address

PO Box 261485
San Diego, CA 92196-1485
Phone (714) 557-5506

Other identifiers 1

IdentifierTypeStateIssuer
550001885OtherCACDPH LICENSE

Other names 1

  • Advantage Health Systems Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111019000499 CA Part A Provider - Home Health Agency 9234300385 Practice locations: Costa Mesa, CA

Home health agency certification: CCN 059511

Legal name
EGB HOLDINGS
Doing business as
ADVANTAGE HEALTH SYSTEMS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 26, 2013
Last certification
Mar 28, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 24, 2011 in CA
Enrollment address
151 Kalmus Dr
Ste D101
Costa Mesa, CA 92626-5959
HHA Branch

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advantage Health SystemsCCN 059511
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 26, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Advantage Health Systems4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

151 Kalmus Dr
Ste D101
Costa Mesa, CA 92626
Phone (714) 557-5506

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Emil G Bundang Individual 5% Or Greater Direct Ownership InterestCeo Feb 24, 2011 100%
Corporate OfficerCeo Mar 19, 2011 100%
Corporate DirectorCeo Mar 19, 2011 100%
W-2 Managing EmployeeCeo Mar 19, 2011 100%
Ma Lei Corpuz Individual W-2 Managing Employee Aug 27, 2019
Maria Cecilia Punay Individual W-2 Managing Employee Aug 27, 2019
Arnel Manalo Individual Corporate OfficerSecretary Board Member Mar 19, 2011
Donna Lee Santos Individual Corporate OfficerTreasurer Board Member Mar 19, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1023305331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261485",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921961485",
            "telephone_number": "714-557-5506",
            "fax_number": "714-557-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KALMUS DR STE D101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265959",
            "telephone_number": "714-557-5506",
            "fax_number": "714-557-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGB HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "BUNDANG",
        "authorized_official_first_name": "EMIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-557-5506"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPH LICENSE",
            "identifier": "550001885",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Health Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.