Provider Demographics
NPI:1386883023
Name:ANGEL CITY HEALTHCARE, INC
Entity type:Organization
Organization Name:ANGEL CITY HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEKSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURATOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-601-1024
Mailing Address - Street 1:425 S FAIRFAX AVE
Mailing Address - Street 2:STE 225
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3541
Mailing Address - Country:US
Mailing Address - Phone:323-601-1024
Mailing Address - Fax:323-328-1735
Practice Address - Street 1:425 S FAIRFAX AVE
Practice Address - Street 2:STE 225
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3541
Practice Address - Country:US
Practice Address - Phone:323-601-1024
Practice Address - Fax:323-328-1735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health