MEDICARE: SILVER WISDOM HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	251X00000X	Supports Brokerage Agency
3	332U00000X	Home Delivered Meals
4	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1437834967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER WISDOM HEALTHCARE

Provider Business Mailing Address
First Line	:	1714 IVAR AVE UNIT D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5124
Country	:	US
Telephone Number	:	323-464-9161
Fax Number	:	323-464-9166

Provider Business Practice Location Address
First Line	:	1714 IVAR AVE UNIT D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5124
Country	:	US
Telephone Number	:	323-464-9161
Fax Number	:	323-464-9166

Authorized Official
Title or Position	:	ECM DIRECTOR
Name	:	ANNA HARTUNIAN
Credential	:
Telephone Number	:	818-404-7555

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	01/30/2025

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Directions to “SILVER WISDOM HEALTHCARE ” Practice Location

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