Mallari Healthcare, Inc.
Organization Active NPI Home Health Agency · Pleasanton, CA
NPI 1225280951 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1225280951
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- MALLARI HEALTHCARE, INC.
- Practice address
- 6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034 - Phone
- (925) 271-0221
- Fax
- (925) 800-3093
- NPI assigned
- Oct 13, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Roel J. M. Mallari, BS CIVIL ENGINEERING
- Title
- Ceo
- Phone
- (925) 271-0221
Practitioners 1
Affiliated clinicians 30
-
Ronald Albert Arakelian, M.D.
-
Edward Leonard Auen, PH.D., M.D.
-
Jincy Clement, M.D.
-
Gervacio D Diaz III, M.D.
-
Daryl Ray Dutter, M.D.
-
Diego F. Ferro, M.D.
-
Victor Santos Flauta, M.D.
-
Edmond Ghahramani, M.D.
-
Mita R Gordo, MD
-
Harpreet Singh Grewal, M.D.
-
Sara Hamidi, M.D.
-
William J Holmes, MD
-
Kent Alan Hufford, M.D.
-
Wesley E Kinzie, MD
-
Soma Krishnamoorthi, M.D.
-
Alex E. Mari, M.D.
-
Rahul Lalitchandra Patel, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Lifeguard Home Health
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Sep 3, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 059055
- Legal name
- MALLARI HEALTHCARE INC
- Doing business as
- LIFEGUARD HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 3, 2009
- Last certification
- Aug 10, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 23, 2008 in CA
- Enrollment address
- 6700 Koll Center Pkwy
Ste 116
Pleasanton, CA 94566-7032
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Roel Mallari |
5% Or Greater Direct Ownership Interest | Oct 20, 2008 | 29% |
| Corporate Director | Oct 20, 2008 | ||
| Jeffrey Mallari |
5% Or Greater Direct Ownership Interest | Oct 20, 2008 | 15% |
| Corporate Director | Oct 20, 2008 | ||
| Consuelo Lemye |
5% Or Greater Direct Ownership Interest | Oct 20, 2008 | 5% |
| Corporate Director | Oct 20, 2008 | ||
| W-2 Managing Employee | Oct 20, 2008 | ||
| Editha M Mallari |
5% Or Greater Direct Ownership Interest | Oct 20, 2008 | 51% |
| Corporate Director | Oct 20, 2008 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081113000111 | CA | Part a Provider - Home Health Agency | 9537228010 | Practice locations: Pleasanton, CA |
National Provider Directory
Locations
371 Gresel St
Hayward, CA 94544
Phone (510) 401-0007
5976 W Las Positas Blvd
Ste 106
Pleasanton, CA 94588
Phone (925) 271-0221
6700 Koll Center Pkwy
Ste 116
Pleasanton, CA 94566
Phone (925) 271-0221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034
Mailing address
6700 Koll Center Pkwy Ste 116
Pleasanton, CA 94566-7034
Phone (925) 271-0221
Other names
- LifeGuard Home Health
Other providers in Pleasanton, CA
- Ruby Maini
- Neepa Makim
- Mahesh Makwana
- Christopher Mina Malek
- Hisham Malik
- Navin A Mallavaram
- Ann Mallory
- Sakyla N Malone
- Amanda Maloney
- Kieran Louise Maloon
All providers in Pleasanton, CA · Home Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.