=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144546268
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZANA MED, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2010
-----------------------------------------------------
Last Update Date | 04/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18840 VENTURA BLVD SUITE 103
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-345-1850
-----------------------------------------------------
Fax | 818-345-1940
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18840 VENTURA BLVD SUITE 103
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-345-1850
-----------------------------------------------------
Fax | 818-345-1940
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | TORNIK K KARAPETYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-345-1850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 2014
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------