Healthcare Provider Details

I. General information

NPI: 1922404870
Provider Name (Legal Business Name): ROYAL OAK RESIDENCE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10458 PLAINVIEW AVE
TUJUNGA CA
91042-1716
US

IV. Provider business mailing address

10458 PLAINVIEW AVE
TUJUNGA CA
91042-1716
US

V. Phone/Fax

Practice location:
  • Phone: 877-250-2404
  • Fax: 877-458-5586
Mailing address:
  • Phone: 877-250-2404
  • Fax: 877-458-5586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ZARUI KHACHATRYAN
Title or Position: CEO
Credential:
Phone: 877-250-2404