MEDICARE: ABC ACADEMY USA

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	252Y00000X	Early Intervention Provider Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1528931979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC ACADEMY USA

Provider Business Mailing Address
First Line	:	5032 N NORTH MAYWOOD AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-2054
Country	:	US
Telephone Number	:	747-231-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	5032 NORTH MAYWOOD AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-2054
Country	:	US
Telephone Number	:	747-231-9888
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANI SAGHATELYAN
Credential	:
Telephone Number	:	747-231-9888

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ABC ACADEMY USA ” Practice Location

Language	Start Address	Practice Location

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