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General NPI Number Information
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NPI Number | 1124505797
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Entity Type | Organization
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Legal Business Name | DISTINGUISHED CARE HOME HEALTH, INC.
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 229 N CENTRAL AVE STE 200
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City | GLENDALE
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State | CA
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Zip | 91203-3555
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Country | US
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Telephone | 818-523-2494
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Fax | 818-396-4235
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Provider Business Mailing Address
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Address Line | 229 N CENTRAL AVE STE 200
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City | GLENDALE
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State | CA
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Zip | 91203-3555
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Country | US
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Telephone | 818-523-2494
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. MATIN RAJABOV
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Credential |
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Telephone | 818-484-7262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | CA
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