Healthcare Provider Details

I. General information

NPI: 1447479035
Provider Name (Legal Business Name): GMA MANAGEMENT GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13117 VAN NUYS BLVD
PACOIMA CA
91331-2559
US

IV. Provider business mailing address

13117 VAN NUYS BLVD
PACOIMA CA
91331-2559
US

V. Phone/Fax

Practice location:
  • Phone: 818-686-0701
  • Fax: 818-686-0751
Mailing address:
  • Phone: 818-686-0701
  • Fax: 818-686-0751

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: AKOP BOULANIKIAN
Title or Position: PRESIDENT
Credential:
Phone: 818-686-0701