Provider Demographics
NPI:1225498645
Name:ST PAUL HOME HEALTH
Entity Type:Organization
Organization Name:ST PAUL HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-488-1485
Mailing Address - Street 1:10349 BALBOA BLVD #202
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-7378
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10349 BALBOA BLVD #202
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-7378
Practice Address - Country:US
Practice Address - Phone:818-488-1485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory