Provider Demographics
NPI:1578255261
Name:NUTRIX CARE PARTNERS, A PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:NUTRIX CARE PARTNERS, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAGOP
Authorized Official - Middle Name:
Authorized Official - Last Name:MKROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-317-7741
Mailing Address - Street 1:221 N CHEVY CHASE DR APT E
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4560
Mailing Address - Country:US
Mailing Address - Phone:818-317-7741
Mailing Address - Fax:
Practice Address - Street 1:1111 N BRAND BLVD STE 312
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3071
Practice Address - Country:US
Practice Address - Phone:323-230-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty