Healthcare Provider Details

I. General information

NPI: 1639032014
Provider Name (Legal Business Name): AN OLD TIMERS HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8905 GLENOAKS BLVD UNIT D
SUN VALLEY CA
91352-2087
US

IV. Provider business mailing address

8905 GLENOAKS BLVD UNIT D
SUN VALLEY CA
91352-2087
US

V. Phone/Fax

Practice location:
  • Phone: 888-525-5543
  • Fax: 818-504-8170
Mailing address:
  • Phone: 888-525-5543
  • Fax: 818-504-8170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HARUTYUN HARUTYUNYAN
Title or Position: CEO
Credential:
Phone: 888-525-5543