Active NPI
Kheir Mirae Adult Day Health Care Center
- Adult Day Care Clinic/Center
- Los Angeles, CA
National Provider Identifier
1396964110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- License
- 060000909
- Legal business name
- KHEIR MIRAE ADULT DAY HEALTH CARE CENTER
- Practice address
- 717 S Western Ave.
Los Angeles, CA 90005-3113 - Phone
- (213) 427-4000
- NPI assigned
- Apr 24, 2007
- Organization subpart
- Yes
- Parent organization
- KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Erin Pak
- Title
- Ceo - Adhc Administrator
- Phone
- (213) 427-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 060000909 | CA | Primary |
Addresses
Primary practice location
717 S Western Ave.
Los Angeles, CA 90005-3113
Mailing address
3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ADU70398F | Other | CA | PROVIDER NUMBER |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2249334 | Kheir Mirae Adult Day Health Care Center | Certificate of waiver | Jan 18, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Kheir Adult Day Health Care Center - Vermont
- Part of
- Kheir Adult Day Health Care Center - Vermont
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Los Angeles, CA
- NPI 1861610859
-
- Primary Care Clinic/Center
- Los Angeles, CA
- NPI 1255296000
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1396329199
-
- Primary Care Clinic/Center
- Los Angeles, CA
- NPI 1902568330
-
dba Kheir Pharmacy
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1093562589
-
- Primary Care Clinic/Center
- Los Angeles, CA
- NPI 1255066833
Locations
14627 S Western Ave
Gardena, CA 90249
Phone (213) 804-7346
3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500
717 S Western Ave
Los Angeles, CA 90005
Phone (213) 427-4000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604448000000",
"number": "1396964110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3727 W 6TH ST STE 210",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900205108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 S WESTERN AVE.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900053113",
"telephone_number": "213-427-4000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KHEIR MIRAE ADULT DAY HEALTH CARE CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER",
"enumeration_date": "2007-04-24",
"last_updated": "2020-11-04",
"certification_date": "2020-11-03",
"status": "A",
"authorized_official_last_name": "PAK",
"authorized_official_first_name": "ERIN",
"authorized_official_title_or_position": "CEO - ADHC ADMINISTRATOR",
"authorized_official_telephone_number": "213-427-4000"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "CA",
"license": "060000909",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "ADU70398F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.