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General NPI Number Information
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NPI Number | 1447281456
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Entity Type | Organization
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Legal Business Name | PANACEA HHC INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 4652 HOLLYWOOD BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90027-5408
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Country | US
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Telephone | 323-953-9392
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Fax | 323-315-2205
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Provider Business Mailing Address
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Address Line | 4652 HOLLYWOOD BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90027-5408
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Country | US
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Telephone | 323-953-9392
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Fax | 323-315-2205
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Authorized Official
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Title or Position | CEO
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Name | MR. SAMUEL GASPARYAN
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Credential |
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Telephone | 13239539392
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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 | 550000294
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License Number State | CA
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