Organization Active NPI

Unified Care Providers, Inc.

  • Home Health Agency
  • Irvine, CA
National Provider Identifier
1689997215
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
UNIFIED CARE PROVIDERS, INC.
Practice address
1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748
Phone
(949) 788-0907
Fax
(949) 681-8326
NPI assigned
Mar 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
Mr. Farzad Afravi, LVN
Title
Cfo/Administrator
Phone
(949) 788-0907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748

Mailing address

1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748
Phone (949) 788-0907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000222 CA Part A Provider - Home Health Agency 7416137567 Practice locations: Irvine, CA

Home health agency certification: CCN 059390

Legal name
UNIFIED CARE PROVIDERS, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 11, 2012
Last certification
Feb 8, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 11, 2009 in CA
Enrollment address
1 Peters Canyon Rd
Ste 160B
Irvine, CA 92606-1748

Care Compare: Home health agency

Medicare Care Compare
Listed as
Unified Care Providers, IncCCN 059390
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jan 11, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2016243Unified Care Providers Inc1 Peters Canyon Rd Ste 160, Irvine, CA 92606Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory

Locations

15775 Laguna Canyon Rd
Ste 180
Irvine, CA 92618
Phone (949) 788-0907

1 Peters Canyon Rd
Ste 160B
Irvine, CA 92606
Phone (949) 788-0907

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Yong B Jun Individual 5% Or Greater Direct Ownership InterestCeo/Board Member Oct 15, 2012 75%
Corporate OfficerCeo/Board Member Jul 22, 2019 25%
W-2 Managing EmployeeCeo/Board Member Oct 15, 2012 25%
Operational/Managerial ControlCeo/Board Member Oct 15, 2012 25%
Farzad Afravi Individual 5% Or Greater Direct Ownership InterestCfo/Secretary/Board Member Jul 22, 2019 50%
Corporate OfficerCfo/Secretary/Board Member Jul 22, 2019 50%
Corporate DirectorCfo/Secretary/Board Member Jul 22, 2019 50%
W-2 Managing EmployeeCfo/Secretary/Board Member Jul 22, 2019 50%
Operational/Managerial ControlCfo/Administrator Jul 22, 2019 50%
Shohreh Forouzanfar Individual Corporate OfficerBoard Member Jul 22, 2019 25%
Corporate DirectorBoard Member Jul 22, 2019 25%
W-2 Managing EmployeeBoard Member Jul 22, 2019 25%
Operational/Managerial ControlBoard Member Jul 22, 2019 25%
Soo Yeoun Kim Individual 5% Or Greater Direct Ownership Interest Sep 14, 2009 25%

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1689997215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PETERS CANYON RD STE 160B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061748",
            "telephone_number": "949-788-0907",
            "fax_number": "949-681-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PETERS CANYON RD STE 160B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061748",
            "telephone_number": "949-788-0907",
            "fax_number": "949-681-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIFIED CARE PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "AFRAVI",
        "authorized_official_first_name": "FARZAD",
        "authorized_official_title_or_position": "CFO/ADMINISTRATOR",
        "authorized_official_telephone_number": "949-788-0907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.