Provider Demographics
NPI:1467054080
Name:SOCAL MEDICAL HOME HEALTH
Entity Type:Organization
Organization Name:SOCAL MEDICAL HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-800-6553
Mailing Address - Street 1:13735 VICTORY BLVD STE 16
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6738
Mailing Address - Country:US
Mailing Address - Phone:747-800-6553
Mailing Address - Fax:925-526-0658
Practice Address - Street 1:13735 VICTORY BLVD STE 16
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-6738
Practice Address - Country:US
Practice Address - Phone:747-800-6553
Practice Address - Fax:925-526-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health