Provider Demographics
NPI:1003029703
Name:VERDUGO HOME HEALTH, INC
Entity Type:Organization
Organization Name:VERDUGO HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIKORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-257-5115
Mailing Address - Street 1:4170 VERDUGO RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3821
Mailing Address - Country:US
Mailing Address - Phone:818-434-7436
Mailing Address - Fax:
Practice Address - Street 1:4170 VERDUGO RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3821
Practice Address - Country:US
Practice Address - Phone:818-434-7436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059166Medicaid
CA059166Medicaid