Healthcare Provider Details

I. General information

NPI: 1174601280
Provider Name (Legal Business Name): VERDUGO VALLEY CONVALESCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 TOPANGA CANYON BLVD #207
CHATSWORTH CA
91311-5759
US

IV. Provider business mailing address

9420 TOPANGA CANYON BLVD #207
CHATSWORTH CA
91311-5759
US

V. Phone/Fax

Practice location:
  • Phone: 818-882-7740
  • Fax: 818-882-7764
Mailing address:
  • Phone: 818-882-7740
  • Fax: 818-882-7764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: BARBARA KHATCHADURIAN
Title or Position: VP
Credential:
Phone: 818-882-7740