Organization
BLUE LOTUS HEALTHCARE HOLDING CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDANA AMIN NAZAR (CEO)
(310) 467-0661
Entity
Organization
Contact information
Practice address
20944 SHERMAN WAY STE 112, CANOGA PARK, CA 91303-3629
(310) 467-0661
Mailing address
3712 PASEO PRIMARIO, CALABASAS, CA 91302-3054
(310) 467-0661
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/15/2022
Last updated
11/10/2023
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