Provider Demographics
NPI:1417464389
Name:PAX HOME HEALTH
Entity Type:Organization
Organization Name:PAX HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LALA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYANDURYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-518-1001
Mailing Address - Street 1:9741 WHEATLAND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9741 WHEATLAND AVE STE 3
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-1403
Practice Address - Country:US
Practice Address - Phone:818-518-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health