Healthcare Provider Details

I. General information

NPI: 1114635356
Provider Name (Legal Business Name): NURSE NEXT DOOR HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W ROUTE 66 STE 22
GLENDORA CA
91740-4377
US

IV. Provider business mailing address

502 W ROUTE 66 STE 22
GLENDORA CA
91740-4377
US

V. Phone/Fax

Practice location:
  • Phone: 323-326-6281
  • Fax: 626-779-7009
Mailing address:
  • Phone: 323-326-6281
  • Fax: 626-779-7009

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: HARUT GEVORKIAN
Title or Position: CEO
Credential:
Phone: 323-326-6281