Healthcare Provider Details

I. General information

NPI: 1760695969
Provider Name (Legal Business Name): PARADISE ADULT DAY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 SANTA MONICA BLVD
LOS ANGELES CA
90029-2014
US

IV. Provider business mailing address

4414 SANTA MONICA BLVD
LOS ANGELES CA
90029-2014
US

V. Phone/Fax

Practice location:
  • Phone: 323-660-1647
  • Fax: 323-661-4226
Mailing address:
  • Phone: 323-660-1647
  • Fax: 323-661-4226

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: ANDRANIK ZAKARYAN
Title or Position: PRESIDENT
Credential:
Phone: 323-660-1647