MEDICARE: VILIK HARUTYUNYAN

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	:	1033859566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VILIK HARUTYUNYAN

Provider Business Mailing Address
First Line	:	8123 SAN FERNANDO RD STE E
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-4005
Country	:	US
Telephone Number	:	818-850-4060
Fax Number	:	818-952-0772

Provider Business Practice Location Address
First Line	:	8123 SAN FERNANDO RD STE E
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-4005
Country	:	US
Telephone Number	:	818-850-4060
Fax Number	:	818-952-0772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	03/31/2022

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Directions to “ VILIK HARUTYUNYAN ” Practice Location

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