Healthcare Provider Details
I. General information
NPI: 1528181831
Provider Name (Legal Business Name): DUGLAS HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2007
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1404 W SUNSET BLVD
LOS ANGELES CA
90026-3432
US
IV. Provider business mailing address
1404 W SUNSET BLVD
LOS ANGELES CA
90026-3432
US
V. Phone/Fax
- Phone: 213-250-9364
- Fax: 213-250-9376
- Phone: 213-250-9364
- Fax: 213-250-9376
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 000219155700019 |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
GAYANE
NALCHADZHYAN
Title or Position: PRESEDENT
Credential:
Phone: 818-667-6903