Healthcare Provider Details

I. General information

NPI: 1952646572
Provider Name (Legal Business Name): SOCHI COMMUNITY BASED ADULT SERVICES INC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 10/03/2015
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

1140 WINCHESTER AVE SUITE 23
GLENDALE CA
91201-3514
US

V. Phone/Fax

Practice location:
  • Phone: 818-903-0137
  • Fax: 818-646-1313
Mailing address:
  • Phone: 818-903-0137
  • Fax: 818-646-1313

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: MR. VAHAN VICTOR MARUKYAN
Title or Position: PRESIDENT/TREASURER
Credential:
Phone: 818-903-0137