Fillmore Country Club

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FILLMORE COUNTRY CLUB

Practice address

827 River St
Fillmore, CA 93015-1818

Phone

(805) 524-7979

NPI assigned

Jun 20, 2013

Last updated

Jun 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenq H Chen

Title

Chairman/President

Phone

(310) 889-9929

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1336588557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 PONTIUS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 RIVER ST",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151818",
            "telephone_number": "805-524-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILLMORE COUNTRY CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "JENQ",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHAIRMAN/PRESIDENT",
        "authorized_official_telephone_number": "310-889-9929"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Epiphany Care Homes Inc (Winter Haven Home ICF/DD-H)
• Gene Wayne Evans, D.D.S.
• Giselle Fernandez, DDS
• Fillmore Area Transit Corp (Sun Shuttle and Transit)
• Fillmore Convalescent Center, LLC
• Fillmore Unified School District
• Melissa Flores
• Kristen Rene Bustillos Fragoso, MSW
• Garfield Beach CVS LLC
• Alvaro Nathan Garnica

• Assisted Living Facility in Fillmore, CA
• Providers in Fillmore, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.