Provider Demographics
NPI:1508046400
Name:MAXCARE COMFORT
Entity Type:Organization
Organization Name:MAXCARE COMFORT
Other - Org Name:MAXCARE MEDICAL COMFORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FNDRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-830-3157
Mailing Address - Street 1:8940 WOODMAN AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6445
Mailing Address - Country:US
Mailing Address - Phone:818-830-3157
Mailing Address - Fax:818-830-3285
Practice Address - Street 1:8940 WOODMAN AVE
Practice Address - Street 2:SUITE G
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6445
Practice Address - Country:US
Practice Address - Phone:818-830-3157
Practice Address - Fax:818-830-3285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49087332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6145000001Medicare NSC