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General NPI Number Information
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NPI Number | 1437642584
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Entity Type | Individual
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Provider Name | LEVON NIKOGHOSYAN
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Gender | Male
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 17514 VENTURA BLVD # 101-105
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City | ENCINO
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State | CA
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Zip | 91316-3852
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Country | US
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Telephone | 818-667-8838
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Fax | 855-221-7773
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Provider Business Mailing Address
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Address Line | 5404 WHITSETT AVE UNIT 29
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City | VALLEY VLG
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State | CA
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Zip | 91607-1615
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Country | US
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Telephone | 818-667-8838
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Fax | 855-221-7773
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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