Healthcare Provider Details

I. General information

NPI: 1790496883
Provider Name (Legal Business Name): PALA HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W ALAMEDA AVE UNIT 103-A
BURBANK CA
91502-2569
US

IV. Provider business mailing address

209 W ALAMEDA AVE UNIT 103-A
BURBANK CA
91502-2569
US

V. Phone/Fax

Practice location:
  • Phone: 473-369-9817
  • Fax: 818-688-3876
Mailing address:
  • Phone: 473-369-9817
  • Fax: 818-688-3876

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: VARDUI YEPREMYAN
Title or Position: CEO
Credential:
Phone: 747-336-9981