Healthcare Provider Details

I. General information

NPI: 1114887494
Provider Name (Legal Business Name): GRAND CARE MOBILE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13609 VICTORY BLVD STE 125
VAN NUYS CA
91401-6410
US

IV. Provider business mailing address

13609 VICTORY BLVD STE 125
VAN NUYS CA
91401-6410
US

V. Phone/Fax

Practice location:
  • Phone: 310-295-0727
  • Fax: 310-295-0956
Mailing address:
  • Phone: 310-295-0727
  • Fax: 310-295-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ARMEN TITIZYAN
Title or Position: CEO
Credential: FNP
Phone: 818-687-7853