Healthcare Provider Details

I. General information

NPI: 1720740368
Provider Name (Legal Business Name): OTIUM HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18425 BURBANK BLVD STE 705
TARZANA CA
91356-2806
US

IV. Provider business mailing address

18425 BURBANK BLVD STE 705
TARZANA CA
91356-2806
US

V. Phone/Fax

Practice location:
  • Phone: 818-659-0950
  • Fax: 818-935-6035
Mailing address:
  • Phone: 818-659-0950
  • Fax: 818-935-6035

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: MR. GEVORG MELKONYAN
Title or Position: CEO
Credential:
Phone: 818-659-0950