MEDICARE: PANACEA HHC 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	550000294	CA

General Provider Information

NPI Number	:	1447281456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANACEA HHC INC

Provider Business Mailing Address
First Line	:	4652 HOLLYWOOD BLVD
Second Line	:	SUITE 103
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5408
Country	:	US
Telephone Number	:	323-953-9392
Fax Number	:	323-315-2205

Provider Business Practice Location Address
First Line	:	4652 HOLLYWOOD BLVD
Second Line	:	SUITE 103
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5408
Country	:	US
Telephone Number	:	323-953-9392
Fax Number	:	323-315-2205

Authorized Official
Title or Position	:	CEO
Name	:	MR. SAMUEL GASPARYAN
Credential	:
Telephone Number	:	13239539392

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/13/2010

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