Provider Demographics
NPI:1992254650
Name:ALLOY HEALTH GROUP
Entity type:Organization
Organization Name:ALLOY HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAROUT
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ANTONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-209-1919
Mailing Address - Street 1:1108 E PALMER AVE
Mailing Address - Street 2:STE 19
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2578
Mailing Address - Country:US
Mailing Address - Phone:818-209-1919
Mailing Address - Fax:844-273-4456
Practice Address - Street 1:1108 E PALMER AVE
Practice Address - Street 2:STE 19
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2578
Practice Address - Country:US
Practice Address - Phone:818-209-1919
Practice Address - Fax:844-273-4456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health