Petra Healthcare Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PETRA HEALTHCARE INC

Practice address

6910 Oslo Cir Ste 204
Buena Park, CA 90621-3348

Phone

(714) 770-0152

NPI assigned

Jun 24, 2021

Organization subpart

No

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

Authorized official

Name

Marck Anton S Tamayo

Title

Compliance Officer

Phone

(714) 829-8903

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1376113100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 OSLO CIR STE 204",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906213348",
            "telephone_number": "714-770-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 OSLO CIR STE 204",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906213348",
            "telephone_number": "714-770-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "TAMAYO",
        "authorized_official_first_name": "MARCK ANTON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "714-829-8903"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonal Patel
• Christopher Matthew Patuwo, DDS
• Gabriela Peinado
• Elizabeth Perez
• Cassandra Anne Peterson-Solano
• Trisha Pfeiffer
• Evan Pham
• Huong Quynh Pham, PHARM. D.
• Kim Thanh Thi Pham, DDS
• Minh H. Pham, D.P.T.

• Community Based Hospice Care Agency in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.