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General NPI Number Information
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NPI Number | 1164017505
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Entity Type | Organization
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Legal Business Name | LA HEALTH NET
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 3527 OCEAN VIEW BLVD # 103
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City | GLENDALE
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State | CA
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Zip | 91208-1211
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Country | US
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Telephone | 657-229-3656
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Fax |
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Provider Business Mailing Address
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Address Line | 3527 OCEAN VIEW BLVD # 103
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City | GLENDALE
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State | CA
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Zip | 91208-1211
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Country | US
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Telephone | 310-666-3791
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Fax | 818-230-9025
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Authorized Official
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Title or Position | CEO
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Name | BLAGOVEST SHOPSKI
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Credential |
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Telephone | 310-666-3791
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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 |
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