MEDICARE: CALIFORNIA COVER HOME HEALTH

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1134846686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA COVER HOME HEALTH

Provider Business Mailing Address
First Line	:	360 W COLORADO ST STE C
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-645-0055
Fax Number	:	818-743-7722

Provider Business Practice Location Address
First Line	:	360 W COLORADO ST STE C
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1603
Country	:	US
Telephone Number	:	818-645-0055
Fax Number	:	818-743-7722

Authorized Official
Title or Position	:	CEO
Name	:	VANIK VARTOOMIAN
Credential	:
Telephone Number	:	818-645-0055

Provider Enumeration Date	:	10/25/2022
Last Update Date	:	01/18/2024

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