=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891524831
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NOVOMED HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2024
-----------------------------------------------------
Last Update Date | 07/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26140 GRAVETT PL
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-3054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-282-1944
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26140 GRAVETT PL
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-3054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-282-1944
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DAVIT ZAKARYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-282-1944
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------