Provider Demographics
NPI:1548396393
Name:GUARDIAN ANGEL HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:GUARDIAN ANGEL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARAPET
Authorized Official - Middle Name:
Authorized Official - Last Name:TILFIZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-550-8200
Mailing Address - Street 1:5827 YORK BLVD
Mailing Address - Street 2:UNIT C
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2634
Mailing Address - Country:US
Mailing Address - Phone:323-550-8200
Mailing Address - Fax:323-550-8133
Practice Address - Street 1:5827 YORK BLVD
Practice Address - Street 2:UNIT C
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-2634
Practice Address - Country:US
Practice Address - Phone:323-550-8200
Practice Address - Fax:323-550-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058275Medicare ID - Type UnspecifiedHOME HEALTH AGENCY