Healthcare Provider Details

I. General information

NPI: 1487929162
Provider Name (Legal Business Name): LA GUARDIAN HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 FOOTHILL BLVD SUITE 203B
TUJUNGA CA
91042-2765
US

IV. Provider business mailing address

6501 FOOTHILL BLVD SUITE 203B
TUJUNGA CA
91042-2765
US

V. Phone/Fax

Practice location:
  • Phone: 818-273-9807
  • Fax: 818-495-2523
Mailing address:
  • Phone: 818-273-9807
  • Fax: 818-495-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROUZANNA DAVITIAN
Title or Position: OWNER
Credential:
Phone: 818-273-9807