MEDICARE: ASTRO 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	:	1205564390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRO HOME HEALTH

Provider Business Mailing Address
First Line	:	6618 SAN FERNANDO RD STE 208
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6618 SAN FERNANDO RD STE 208
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1703
Country	:	US
Telephone Number	:	747-254-0707
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOSEPH AYVAZYAN
Credential	:
Telephone Number	:	747-254-0707

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	08/08/2022

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Directions to “ASTRO HOME HEALTH ” Practice Location

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