Healthcare Provider Details

I. General information

NPI: 1013425305
Provider Name (Legal Business Name): LOYAL CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2018
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12385 JOLETTE AVE
GRANADA HILLS CA
91344-1633
US

IV. Provider business mailing address

12385 JOLETTE AVE
GRANADA HILLS CA
91344-1633
US

V. Phone/Fax

Practice location:
  • Phone: 818-404-5005
  • Fax:
Mailing address:
  • Phone: 818-400-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: HAMBARSOOM REZKWA
Title or Position: CEO
Credential:
Phone: 818-404-5005