Provider Demographics
NPI:1417576588
Name:ADVANTAGE HEALTH SOLUTIONS INC
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NOGOL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-326-8395
Mailing Address - Street 1:506 S SPRING #13308
Mailing Address - Street 2:SMB 7649
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013
Mailing Address - Country:US
Mailing Address - Phone:559-326-8395
Mailing Address - Fax:
Practice Address - Street 1:860 HAMPSHIRE RD STE P
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-6020
Practice Address - Country:US
Practice Address - Phone:805-852-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty