Healthcare Provider Details

I. General information

NPI: 1306507991
Provider Name (Legal Business Name): ANOOSH HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 S SEPULVEDA BLVD STE 1174
LOS ANGELES CA
90034-6060
US

IV. Provider business mailing address

3415 S SEPULVEDA BLVD STE 1174
LOS ANGELES CA
90034-6060
US

V. Phone/Fax

Practice location:
  • Phone: 818-800-0506
  • Fax:
Mailing address:
  • Phone: 818-800-0506
  • Fax:

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: DAVID BAZIKIAN
Title or Position: CEO/OWNER
Credential:
Phone: 818-800-0506