Healthcare Provider Details
I. General information
NPI: 1861472672
Provider Name (Legal Business Name): HOVIG NARGIZIAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2006
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15434 DEVONSHIRE ST
MISSION HILLS CA
91345-2619
US
IV. Provider business mailing address
15434 DEVONSHIRE ST
MISSION HILLS CA
91345-2619
US
V. Phone/Fax
- Phone: 818-830-2445
- Fax: 818-830-1435
- Phone: 818-830-2445
- Fax: 818-830-1435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | SRYAP9720722700002AC |
| License Number State | CA |
VIII. Authorized Official
Name:
HOVIG
J
NARGIZIAN
Title or Position: CEO
Credential:
Phone: 818-830-2445