Provider Demographics
NPI:1194031955
Name:SOCAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:SOCAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KOKO
Authorized Official - Middle Name:
Authorized Official - Last Name:POLOSAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-563-3300
Mailing Address - Street 1:2829 N GLENOAKS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2661
Mailing Address - Country:US
Mailing Address - Phone:818-563-3300
Mailing Address - Fax:818-563-3301
Practice Address - Street 1:2829 N GLENOAKS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2661
Practice Address - Country:US
Practice Address - Phone:818-563-3300
Practice Address - Fax:818-563-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001556251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health