Healthcare Provider Details

I. General information

NPI: 1609503267
Provider Name (Legal Business Name): AH PRIMARY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W GLENOAKS BLVD STE 14
GLENDALE CA
91202-4047
US

IV. Provider business mailing address

8905 GLENOAKS BLVD UNIT D
SUN VALLEY CA
91352-2087
US

V. Phone/Fax

Practice location:
  • Phone: 818-618-7737
  • Fax:
Mailing address:
  • Phone: 818-618-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ARMINE HARUTYUNYAN
Title or Position: CEO
Credential: DNP, FNP, PMHNP
Phone: 818-618-7737