Healthcare Provider Details

I. General information

NPI: 1477626638
Provider Name (Legal Business Name): LA CIENEGA ENTERPRISE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7215 KESTER AVE
VAN NUYS CA
91405-2112
US

IV. Provider business mailing address

7215 KESTER AVE
VAN NUYS CA
91405-2112
US

V. Phone/Fax

Practice location:
  • Phone: 818-786-0590
  • Fax: 818-786-0563
Mailing address:
  • Phone: 818-786-0590
  • Fax: 818-786-0563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number103535
License Number StateCA

VIII. Authorized Official

Name: MR. ARAKEL ARAKELYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-786-0590