MEDICARE: MK HOME HEALTH SERVICES

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	:	1407423379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MK HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	930 COLORADO BLVD STE 1
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1735
Country	:	US
Telephone Number	:	323-640-3016
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 COLORADO BLVD STE 1
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1735
Country	:	US
Telephone Number	:	323-640-3016
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ANNA KUSHKYAN
Credential	:
Telephone Number	:	323-640-3016

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	06/08/2021

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Directions to “MK HOME HEALTH SERVICES ” Practice Location

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