Healthcare Provider Details
I. General information
NPI: 1568008050
Provider Name (Legal Business Name): SUNNYLAND CBAS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1253 E COLORADO BLVD
PASADENA CA
91106-1834
US
IV. Provider business mailing address
1253 E COLORADO BLVD
PASADENA CA
91106-1834
US
V. Phone/Fax
- Phone: 818-455-6633
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARTUSH
KARAPTEYAN
Title or Position: CEO
Credential:
Phone: 818-455-6633