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NPI Code Detail

MEDICARE: CONCORD HOME HEALTH CARE

MEDICARE: CONCORD HOME HEALTH CARE
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
1251E00000XHome Health Agency11432906CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1058215OTHERCATO SERVICE MANAGED CARE PATIENTS THAT HAVE OON BENIFITS

General Provider Information

NPI Number : 1588191274
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCORD HOME HEALTH CARE
Provider Business Mailing Address
First Line : 6824 RADFORD AVE
Second Line : SUITE 1
City : NORTH HOLLYWOOD
State : CA
Zip : 91605
Country : US
Telephone Number : 818-209-1919
Fax Number :
Provider Business Practice Location Address
First Line : 6824 RADFORD AVE
Second Line : SUITE 1
City : NORTH HOLLYWOOD
State : CA
Zip : 91605
Country : US
Telephone Number : 818-209-1919
Fax Number :
Authorized Official
Title or Position : CEO
Name : MARUT ANTONIAN
Credential :
Telephone Number : 818-209-1919
Provider Enumeration Date : 05/12/2017
Last Update Date : 05/12/2017

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Directions to “CONCORD HOME HEALTH CARE ” Practice Location

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