Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Angel 1004 Residential Home

Organization Assisted Living Facility · NPI 1609719764

Angel 1004 Residential Home is an Assisted Living Facility in Fontana, California. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

7142 Verdugo Pl
Fontana, CA 92336-1452
Phone: (909) 855-3105
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1609719764
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Haejin Kim — Licensee · (909) 855-3105
NPI enumeratedApril 13, 2026
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing address7142 Verdugo Pl, Fontana, CA 92336-1452

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