Healthcare Provider Details

I. General information

NPI: 1730108929
Provider Name (Legal Business Name): HOLY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N. GLENDALE BLVD.
LOS ANGELES CA
90026
US

IV. Provider business mailing address

6330 LAUREL CANYON BLVD STE B
NORTH HOLLYWOOD CA
91606-3213
US

V. Phone/Fax

Practice location:
  • Phone: 213-481-9900
  • Fax: 213-481-9944
Mailing address:
  • Phone: 213-481-9900
  • Fax: 213-481-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA83140
License Number StateCA

VIII. Authorized Official

Name: DR. HAKOP OGANYAN
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 213-481-9900