Healthcare Provider Details

I. General information

NPI: 1780806570
Provider Name (Legal Business Name): MEDASSIST HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13107 VENTURA BLVD STE #206
STUDIO CITY CA
91604-2241
US

IV. Provider business mailing address

13107 VENTURA BLVD STE #206
STUDIO CITY CA
91604-2241
US

V. Phone/Fax

Practice location:
  • Phone: 818-501-5221
  • Fax: 818-501-5255
Mailing address:
  • Phone: 818-501-5221
  • Fax: 818-501-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550000342
License Number StateCA

VIII. Authorized Official

Name: MR. MICHAEL MIRETSKY
Title or Position: VICE PRESIDENT
Credential:
Phone: 818-501-5221