Provider Demographics
NPI:1760608996
Name:BABYLON ADHC INC.
Entity Type:Organization
Organization Name:BABYLON ADHC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-996-9172
Mailing Address - Street 1:5955 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1723
Mailing Address - Country:US
Mailing Address - Phone:818-996-9172
Mailing Address - Fax:818-996-9173
Practice Address - Street 1:5955 LINDLEY AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1723
Practice Address - Country:US
Practice Address - Phone:818-996-9172
Practice Address - Fax:818-996-9173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000893302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70365FMedicaid