Healthcare Provider Details

I. General information

NPI: 1417561242
Provider Name (Legal Business Name): HAK MEDICAL CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15424 MARILLA ST
NORTH HILLS CA
91343-2125
US

IV. Provider business mailing address

15424 MARILLA ST
NORTH HILLS CA
91343-2125
US

V. Phone/Fax

Practice location:
  • Phone: 818-915-3544
  • Fax:
Mailing address:
  • Phone: 818-915-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ARTUSH KHACHATRYAN
Title or Position: CEO
Credential:
Phone: 818-915-3544