MEDICARE: HEALTH CHOICE AND DIAGNOSTIC 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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1629251798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH CHOICE AND DIAGNOSTIC INC.

Provider Business Mailing Address
First Line	:	5011 HOLLYWOOD BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5011 HOLLYWOOD BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6103
Country	:	US
Telephone Number	:	818-822-7372
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	ALEX AYRIYAN
Credential	:
Telephone Number	:	818-822-7372

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	12/12/2007

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