Healthcare Provider Details
I. General information
NPI: 1346437571
Provider Name (Legal Business Name): POBEDA SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2007
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7235 FOOTHILL BLVD
TUJUNGA CA
91042-2718
US
IV. Provider business mailing address
7235 FOOTHILL BLVD
TUJUNGA CA
91042-2718
US
V. Phone/Fax
- Phone: 818-353-3224
- Fax: 818-353-1315
- Phone: 818-353-3224
- Fax: 818-353-1315
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | 060000662 |
| License Number State | CA |
VIII. Authorized Official
Name:
ALVINA
TENEKEDJIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-353-3224