Provider Demographics
NPI:1699241091
Name:MEDICUS HOME HEALTH AGENCY
Entity type:Organization
Organization Name:MEDICUS HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-477-2995
Mailing Address - Street 1:21032 DEVONSHIRE ST UNIT 202B
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2368
Mailing Address - Country:US
Mailing Address - Phone:818-477-2995
Mailing Address - Fax:818-477-2855
Practice Address - Street 1:21032 DEVONSHIRE ST UNIT 202B
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2368
Practice Address - Country:US
Practice Address - Phone:818-477-2995
Practice Address - Fax:818-477-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health