Healthcare Provider Details

I. General information

NPI: 1033830435
Provider Name (Legal Business Name): PROMED HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4119 W BURBANK BLVD # 151
BURBANK CA
91505-2122
US

IV. Provider business mailing address

4119 W BURBANK BLVD # 151
BURBANK CA
91505-2122
US

V. Phone/Fax

Practice location:
  • Phone: 818-268-6517
  • Fax: 818-279-6890
Mailing address:
  • Phone: 818-268-6517
  • Fax: 818-279-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AZADOUHI GRIGORYAN
Title or Position: CEO
Credential:
Phone: 818-653-1449