MEDICARE: WEST COAST NURSING VENTURA, 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	:	1134289598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST COAST NURSING VENTURA, INC.

Provider Business Mailing Address
First Line	:	2955 E. HILLCREST DRIVE
Second Line	:	SUITE 121
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-3177
Country	:	US
Telephone Number	:	805-496-0900
Fax Number	:	805-496-0906

Provider Business Practice Location Address
First Line	:	2955 E HILLCREST DR
Second Line	:	SUITE 121
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3176
Country	:	US
Telephone Number	:	805-496-0900
Fax Number	:	805-496-0906

Authorized Official
Title or Position	:	CEO PRESIDENT
Name	:	ARTURIK GYANDZHYAN
Credential	:
Telephone Number	:	805-496-0900

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	08/14/2008

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