Provider Demographics
NPI:1083715379
Name:AMERIOX, INC
Entity Type:Organization
Organization Name:AMERIOX, INC
Other - Org Name:FANTASIA HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BIJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHAGHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-442-0008
Mailing Address - Street 1:1945 PALO VERDE AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3443
Mailing Address - Country:US
Mailing Address - Phone:877-799-4321
Mailing Address - Fax:562-799-1934
Practice Address - Street 1:14555 HAMLIN ST
Practice Address - Street 2:SUITE# 5
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1612
Practice Address - Country:US
Practice Address - Phone:818-442-0008
Practice Address - Fax:818-442-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA70289GMedicaid