MEDICARE: DUGLAS 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	332BX2000X	Oxygen Equipment & Supplies (DME)	000219155700019	CA

General Provider Information

NPI Number	:	1528181831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUGLAS HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1404 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3432
Country	:	US
Telephone Number	:	213-250-9364
Fax Number	:	213-250-9376

Provider Business Practice Location Address
First Line	:	1404 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3432
Country	:	US
Telephone Number	:	213-250-9364
Fax Number	:	213-250-9376

Authorized Official
Title or Position	:	PRESEDENT
Name	:	MR. GAYANE NALCHADZHYAN
Credential	:
Telephone Number	:	818-667-6903

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	08/21/2008

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