Healthcare Provider Details

I. General information

NPI: 1851832414
Provider Name (Legal Business Name): QOR HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11472 GLENOAKS BLVD
PACOIMA CA
91331-1111
US

IV. Provider business mailing address

3311 BEAUDRY TER
GLENDALE CA
91208-1750
US

V. Phone/Fax

Practice location:
  • Phone: 747-225-3729
  • Fax:
Mailing address:
  • Phone: 818-631-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. KHACHATUR SARYAN
Title or Position: PRESIDENT
Credential: D.D.S
Phone: 818-631-0770