MEDICARE: HG HOME CARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1992989719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HG HOME CARE, INC.

Provider Business Mailing Address
First Line	:	14545 FRIAR ST STE 106
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2357
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14545 FRIAR ST STE 106
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2357
Country	:	US
Telephone Number	:	818-909-7886
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HOVSEP GAZAZYAN
Credential	:
Telephone Number	:	818-909-7886

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	12/28/2007

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