Healthcare Provider Details

I. General information

NPI: 1497966030
Provider Name (Legal Business Name): UNICARE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S FAIR OAKS AVE SUITE 104
PASADENA CA
91105-2561
US

IV. Provider business mailing address

301 S FAIR OAKS AVE SUITE 104
PASADENA CA
91105-2561
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-7771
  • Fax: 626-793-7772
Mailing address:
  • Phone: 626-793-7771
  • Fax: 626-793-7772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48448
License Number StateCA

VIII. Authorized Official

Name: MR. ROBERT GEVORKIAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 626-793-7771