Provider Demographics
NPI:1598084162
Name:BRAVO CARE INC
Entity Type:Organization
Organization Name:BRAVO CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATSAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-352-7208
Mailing Address - Street 1:8522 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1912
Mailing Address - Country:US
Mailing Address - Phone:818-352-7208
Mailing Address - Fax:818-352-7302
Practice Address - Street 1:8522 FOOTHILL BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-1912
Practice Address - Country:US
Practice Address - Phone:818-352-7208
Practice Address - Fax:818-352-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport