MEDICARE: BREEZE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1306429980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREEZE HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	5107 HOLLYWOOD BLVD APT 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6116
Country	:	US
Telephone Number	:	323-977-9000
Fax Number	:	323-977-7000

Provider Business Practice Location Address
First Line	:	5107 HOLLYWOOD BLVD APT 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6116
Country	:	US
Telephone Number	:	323-977-9000
Fax Number	:	323-977-7000

Authorized Official
Title or Position	:	CEO
Name	:	KAREN AVETISYAN
Credential	:
Telephone Number	:	323-977-9000

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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