Organization Active NPI

California Healthcare Services

  • Home Health Agency
  • Hawthorne, CA
National Provider Identifier
1861673220
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
24879678 Issued in CA
Legal business name
CALIFORNIA HEALTHCARE SERVICES
Practice address
13658 Hawthorne Blvd
Suite 200a
Hawthorne, CA 90250-5824
Phone
(310) 644-8302
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Authorized official

Name
Mr. Henry Pekun
Title
Cfo
Phone
(310) 877-5368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 24879678 CA Primary

Addresses

Primary practice location

13658 Hawthorne Blvd
Suite 200a
Hawthorne, CA 90250-5824

Mailing address

13658 Hawthorne Blvd
Suite 200a
Hawthorne, CA 90250-5824
Phone (310) 644-8302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071221000566 CA Part A Provider - Home Health Agency 3274623665 Practice locations: Hawthorne, CA

Home health agency certification: CCN 059183

Legal name
CALIFORNIA HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 12, 2010
Last certification
Nov 7, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 19, 2007 in NV
Enrollment address
13658 Hawthorne Blvd
Ste 200a
Hawthorne, CA 90250-5822

Care Compare: Home health agency

Medicare Care Compare
Listed as
California Healthcare ServicesCCN 059183 · All quality measures
Ownership
Proprietary
Certified
Jan 12, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Henry Olanipekun Individual 5% Or Greater Direct Ownership InterestManagerial Dec 1, 2007 100%
Corporate OfficerCeo, Cfo, Board Member Nov 19, 2007 100%
Corporate DirectorCfo Dec 1, 2007 100%
W-2 Managing EmployeeCeo Nov 19, 2007 100%

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 5

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": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345766400000",
    "number": "1861673220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13658 HAWTHORNE BLVD",
            "address_2": "SUITE 200A",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505824",
            "telephone_number": "310-644-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13658 HAWTHORNE BLVD",
            "address_2": "SUITE 200A",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505824",
            "telephone_number": "310-644-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2012-08-24",
        "status": "A",
        "authorized_official_last_name": "PEKUN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-877-5368",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "24879678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.