Healthcare Provider Details

I. General information

NPI: 1124773288
Provider Name (Legal Business Name): OPTUM HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6803 FOOTHILL BLVD STE 3
TUJUNGA CA
91042-2710
US

IV. Provider business mailing address

6803 FOOTHILL BLVD STE 3
TUJUNGA CA
91042-2710
US

V. Phone/Fax

Practice location:
  • Phone: 747-212-4490
  • Fax: 747-212-4491
Mailing address:
  • Phone: 747-212-4490
  • Fax: 747-212-4491

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: ARAM MANOUKIAN
Title or Position: CEO
Credential:
Phone: 747-212-4490