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General NPI Number Information
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NPI Number | 1841415585
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Entity Type | Organization
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Legal Business Name | OPTIMA HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 1545 N VERDUGO RD SUITE 108
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City | GLENDALE
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State | CA
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Zip | 91208-2841
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Country | US
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Telephone | 818-507-6957
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Fax | 818-827-3067
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Provider Business Mailing Address
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Address Line | 1545 N VERDUGO RD SUITE 108
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City | GLENDALE
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State | CA
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Zip | 91208-2841
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Country | US
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Telephone | 818-507-6957
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Fax | 818-827-3067
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Authorized Official
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Title or Position | CEO
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Name | EDVIN E BAGHDASARIANS
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Credential |
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Telephone | 818-507-6957
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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 | 550000739
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License Number State | CA
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