Healthcare Provider Details

I. General information

NPI: 1760856975
Provider Name (Legal Business Name): ROYAL CROWN HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10999 RIVERSIDE DR STE 104
STUDIO CITY CA
91602-2239
US

IV. Provider business mailing address

10999 RIVERSIDE DR STE 104
STUDIO CITY CA
91602-2239
US

V. Phone/Fax

Practice location:
  • Phone: 818-742-6585
  • Fax: 818-350-4401
Mailing address:
  • Phone: 818-742-6585
  • Fax: 818-350-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. MIKE DANIYELYAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 818-742-6585