Active NPI
Egb Holdings
Doing business as Advantage Health Systems
- Community Based Hospice Care Agency
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- EGB HOLDINGS
- Doing business as
- Advantage Health Systems
- Practice address
- 4100 Latham Street
Suite E
Riverside, CA 92501-1733 - Phone
- (951) 393-1333
- Fax
- (951) 393-1555
- NPI assigned
- Oct 4, 2016
- Last updated
- Oct 31, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Emil Bundang
- Title
- Ceo
- Phone
- (951) 393-1333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
4100 Latham Street
Suite E
Riverside, CA 92501-1733
Mailing address
PO Box 261485
San Diego, CA 92196-1485
Phone (951) 393-1333
Other names 1
- Advantage Health Systems
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161027001224 | CA | Part A Provider - Hospice | 9234300385 | Practice locations: Riverside, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1801345731. Details of each certification follow.
Hospice certification: CCN A01600
- Legal name
- EGB HOLDINGS
- Doing business as
- ADVANTAGE HEALTH SYSTEMS
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 14, 2019
- Last certification
- Feb 14, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Feb 24, 2011 in CA
- Enrollment address
- 4100 Latham St
Ste E
Riverside, CA 92501-1733
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Advantage Health Systems
- Home Health Agency
- Costa Mesa, CA
- NPI 1023305331
9234300385
-
dba Advantage Health Systems
- Home Health Agency
- Riverside, CA
- NPI 1558658864
9234300385
-
dba Advantage Health Systems
- Community Based Hospice Care Agency
- Costa Mesa, CA
- NPI 1871942029
9234300385
Care Compare: Hospice
Medicare Care Compare- Listed as
- Advantage Health Systems
- Ownership
- For-Profit
- Certified
- Feb 14, 2019
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Advantage Health Systems
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Advantage Health Systems
- Community Based Hospice Care Agency
- Costa Mesa, CA
- NPI 1871942029
Locations
151 Kalmus Dr
Ste D240
Costa Mesa, CA 92626
Phone (714) 557-5506
4100 Latham St
Ste E
Riverside, CA 92501
Phone (951) 393-1333
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Emil G Bundang | 5% Or Greater Direct Ownership Interest | Feb 24, 2011 | 100% |
| Corporate Officer | Feb 24, 2011 | 100% | |
| Corporate Director | Feb 24, 2011 | 100% | |
| W-2 Managing Employee | Oct 1, 2016 | 100% | |
| Ma Lei Corpuz | W-2 Managing Employee | Sep 27, 2019 | |
| Maria Cecilia Punay | W-2 Managing Employee | Sep 27, 2019 | |
| Ahmad Alazzeh | Contracted Managing Employee | Jun 7, 2023 | |
| Ednaida Tate | W-2 Managing Employee | Feb 20, 2020 | |
| Koohzad Karimi | Contracted Managing Employee | Nov 14, 2008 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Pulmonary Disease Physician
- Riverside, CA
- NPI 1194037945
Contracted Managing Employee
-
- Family Medicine Physician
- Oak Park, IL
- NPI 1376920116
Contracted Managing Employee
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gerontology Nurse Practitioner
- Riverside, CA
- NPI 1013653286
-
- Family Medicine Physician
- Huntington Beach, CA
- NPI 1952890113
-
- Clinical Social Worker
- Murrieta, CA
- NPI 1568009421
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1540944000000",
"number": "1801345731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 261485",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921961485",
"telephone_number": "951-393-1333",
"fax_number": "951-393-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 LATHAM STREET",
"address_2": "SUITE E",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925011733",
"telephone_number": "951-393-1333",
"fax_number": "951-393-1555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EGB HOLDINGS",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-04",
"last_updated": "2018-10-31",
"status": "A",
"authorized_official_last_name": "BUNDANG",
"authorized_official_first_name": "EMIL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "951-393-1333"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Advantage Health Systems",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Advantage Health Systems",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.