Active NPI
California Healthcare Services
- Home Health Agency
- Hawthorne, CA
National Provider Identifier
1861673220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 24879678
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Services
- Ownership
- Proprietary
- Certified
- Jan 12, 2010
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Henry Olanipekun | 5% Or Greater Direct Ownership Interest | Dec 1, 2007 | 100% |
| Corporate Officer | Nov 19, 2007 | 100% | |
| Corporate Director | Dec 1, 2007 | 100% | |
| W-2 Managing Employee | 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.
-
- Ambulatory Care Registered Nurse
- Los Angeles, CA
- NPI 1427764240
-
- Family Medicine Physician
- Bellflower, CA
- NPI 1871172445
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Nephrology Physician
- Los Angeles, CA
- NPI 1619984234
Home health agency
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; 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.