MEDICARE: ANOOSH HOME CARE

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	:	1306507991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOOSH HOME CARE

Provider Business Mailing Address
First Line	:	3415 S SEPULVEDA BLVD STE 1174
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-6060
Country	:	US
Telephone Number	:	818-800-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 S SEPULVEDA BLVD STE 1174
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-6060
Country	:	US
Telephone Number	:	818-800-0506
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DAVID BAZIKIAN
Credential	:
Telephone Number	:	818-800-0506

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	01/05/2022

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