Provider Demographics
NPI:1700220522
Name:PACIFIC HOME HEALTH CARE
Entity Type:Organization
Organization Name:PACIFIC HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-557-7740
Mailing Address - Street 1:425 S VICTORY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2394
Mailing Address - Country:US
Mailing Address - Phone:818-557-7740
Mailing Address - Fax:818-557-7741
Practice Address - Street 1:425 S VICTORY BLVD STE D
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2394
Practice Address - Country:US
Practice Address - Phone:818-557-7740
Practice Address - Fax:818-557-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001608251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health