Healthcare Provider Details

I. General information

NPI: 1124187893
Provider Name (Legal Business Name): YASMINE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19531 PARTHENIA ST
NORTHRIDGE CA
91324-3406
US

IV. Provider business mailing address

19531 PARTHENIA ST
NORTHRIDGE CA
91324-3406
US

V. Phone/Fax

Practice location:
  • Phone: 818-718-7800
  • Fax: 818-718-2777
Mailing address:
  • Phone: 818-718-7800
  • Fax: 818-718-2777

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. BEHROOZ SUMEKH
Title or Position: PRESIDENT
Credential:
Phone: 12133211580