MEDICARE: GOLDEN STAR HOME HEALTH CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1003286873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN STAR HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	440 W COLORADO ST STE 205
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-3056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 W COLORADO ST STE 205
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-3056
Country	:	US
Telephone Number	:	818-967-5501
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. AIDA OVSEPYAN
Credential	:
Telephone Number	:	818-967-5500

Provider Enumeration Date	:	10/05/2015
Last Update Date	:	10/05/2015

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