Provider Demographics
NPI:1962501494
Name:HZOR MEDICAL SERVICES ADHCC
Entity Type:Organization
Organization Name:HZOR MEDICAL SERVICES ADHCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:HZOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-345-1240
Mailing Address - Street 1:740 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-5007
Mailing Address - Country:US
Mailing Address - Phone:626-345-1240
Mailing Address - Fax:
Practice Address - Street 1:7521 CLEON AVE
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4814
Practice Address - Country:US
Practice Address - Phone:818-765-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70341FOtherMEDICAL