MEDICARE: MEDCAREONE

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1871482943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCAREONE

Provider Business Mailing Address
First Line	:	8054 LAUREL CANYON BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1427
Country	:	US
Telephone Number	:	323-505-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8054 LAUREL CANYON BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1427
Country	:	US
Telephone Number	:	323-505-6000
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. KRISTINE HARUTYUNYAN
Credential	:
Telephone Number	:	323-505-6000

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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