MEDICARE: SUNRISE HOME HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1043733421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1131 N PACIFIC AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2358
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1131 N PACIFIC AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2358
Country	:	US
Telephone Number	:	323-707-4005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. POGOS CHEFTEYAN
Credential	:
Telephone Number	:	323-707-4005

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	07/18/2017

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