Cryogen la

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

CRYOGEN LA

Practice address

17331 Wall St
Carson, CA 90746-1166

Phone

(310) 844-1190

NPI assigned

Sep 20, 2022

Last updated

Sep 20, 2022By 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

Daevon Taylor

Title

Owner

Phone

(310) 800-3075

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1417670084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17331 WALL ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461166",
            "telephone_number": "310-844-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17331 WALL ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461166",
            "telephone_number": "310-844-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYOGEN LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DAEVON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-800-3075"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Carson, CA
• Providers in Carson, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.