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NPI Code Detail

MEDICARE: CELEBRITY HEALTHCARE INC.

MEDICARE: CELEBRITY HEALTHCARE 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
1251G00000XCommunity Based Hospice Care Agency
2251E00000XHome Health AgencyAPPLIED FORCA

General Provider Information

NPI Number : 1619249737
Entity Type Code : Organization
Provider Name (Legal Business Name) : CELEBRITY HEALTHCARE INC.
Provider Business Mailing Address
First Line : 16600 SHERMAN WAY
Second Line : SUITE # 200
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-343-4001
Fax Number : 818-343-4001
Provider Business Practice Location Address
First Line : 16600 SHERMAN WAY
Second Line : SUITE # 200
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-343-4001
Fax Number : 818-343-4001
Authorized Official
Title or Position : PRESIDENT
Name : MR. DAVID BUSTAN
Credential :
Telephone Number : 818-343-4001
Provider Enumeration Date : 02/04/2012
Last Update Date : 06/10/2013

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Directions to “CELEBRITY HEALTHCARE INC. ” Practice Location

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